Sam'S Club Optical
Eyewear Supplier (Equipment, not the service) in Baltimore, MD. Organization (NPI-2).
NPI number1720174550
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1720174550
- Entity type
- Organization (NPI-2)
- Legal business name
- Sam'S Club Optical
- Organization subpart
- No
- Enumeration date
- Oct 5, 2006
- Last updated
- Sep 11, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
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 30-6650 (Doing Business As)
Practice location
6410 Petrie Way RdBaltimore, MD 21237-3034
Phone 410-686-2683
Mailing address
702 Sw 8th StreetBentonville, AR 72716-0235
Authorized official
Linda M. Epperson
Npi Coordinator
3167885580
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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