Organization · Type 2 NPI

Sam's East, Inc.

Eyewear Supplier · Orlando, FL

NPI number 1104374420 Active

Practice location

11920 Narcoossee Rd
Orlando, FL 32832-0000

Call (407) 204-8622 Map

Fax (407) 816-8164

Mailing address

702 SW 8th St, Ms 0445
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Optician	156FX1800X	None listed
Eyewear Supplier Primary	332H00000X	None listed

Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

6 other providers at this address

Other eyewear supplier providers in Orlando

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NPI record

NPI: 1104374420
Entity type: Organization (Type 2)
Issued: Sep 15, 2016
Last updated: Jan 4, 2017
Status: Active
Subpart: Yes of Wal-Mart Stores, Inc.

Other names

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Sam's Club Optical 30-4828 · doing business as

Authorized official

Laura Levine
Dir Healthcare Contract & Enroll
(479) 204-8550

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104374420

Sam's East, Inc.'s National Provider Identifier is 1104374420, issued on Sep 15, 2016. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Orlando, FL. The record was last updated on Jan 4, 2017.