Organization · Type 2 NPI

Sam's East Inc

Eyewear Supplier · Athens, GA

NPI number 1578652194 Active

Practice location

4365 Atlanta Hwy
Athens, GA 30606-0808

Call (706) 548-2824 Map

Fax (706) 548-9676

Mailing address

1 Customer Dr, 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.

4 other providers at this address

Other eyewear supplier providers in Athens

See all in Athens →

NPI record

NPI: 1578652194
Entity type: Organization (Type 2)
Issued: Oct 12, 2006
Last updated: Jun 15, 2026
Status: Active

Other names

<unavail>
Sam's Club Optical 30-8194 · doing business as
Sam's Optical Center 30-8194 · doing business as

Authorized official

Kimberly Canonic
SR Director
(480) 853-0515

Verify this record

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.

Is this your record? How to update it.

About NPI 1578652194

Sam's East Inc's National Provider Identifier is 1578652194, issued on Oct 12, 2006. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Athens, GA. The record was last updated on Jun 15, 2026.