Sam'S Club Optical
Technician/Technologist, Optician in North Las Vegas, NV. Organization (NPI-2).
NPI number1114101193
StatusActive
Last updated in NPPESDec 26, 2007
Details
- NPI
- 1114101193
- Entity type
- Organization (NPI-2)
- Legal business name
- Sam'S Club Optical
- Organization subpart
- No
- Enumeration date
- Dec 26, 2007
- Last updated
- Dec 26, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | – | – | Yes |
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – |
Other names
- Sam'S Club Optical 30-4974 (Doing Business As)
Practice location
2650 East Craig RoadNorth Las Vegas, NV 89030
Phone 702-399-3722
Mailing address
702 Sw 8th St.Bentonville, AR 72716-0235
Phone 479-277-9373 · Fax 479-277-8176
Authorized official
David J Simmons
Npi Associate
4792779373
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