Sam'S Club Optical
Eyewear Supplier (Equipment, not the service) in Mcdonough, GA. Organization (NPI-2).
NPI number1053403600
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1053403600
- Entity type
- Organization (NPI-2)
- Legal business name
- Sam'S Club Optical
- Organization subpart
- No
- Enumeration date
- Sep 29, 2006
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – | Yes |
| 156FX1800X | Technician/Technologist, Optician | – | – |
Other names
- Sam'S Club Optical 30-4804 (Doing Business As)
Practice location
1765 Jonesboro RdMcdonough, GA 30253-5969
Phone 770-914-0488
Mailing address
702 Sw 8th StreetBentonville, AR 72716-0235
Authorized official
Linda M. Epperson
Npi Coordinator
3167885580
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