Organization · Type 2 NPI

Sam's East, Inc.

Eyewear Supplier · Woodstock, GA

NPI number 1619347192 Active

Practice location

9464 Main St
Woodstock, GA 30188-3715

Call (678) 402-0540 Map

Fax (770) 928-2013

Mailing address

702 SW 8th St
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.

5 other providers at this address

Other eyewear supplier providers in Woodstock

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NPI record

NPI: 1619347192
Entity type: Organization (Type 2)
Issued: Sep 28, 2015
Last updated: Sep 28, 2015
Status: Active
Subpart: Yes of Wal-Mart Stores, Inc.

Other names

<unavail>
Sam's Club Vision Center 30-8158 · doing business as

Authorized official

Laura Levine
Director of Contract and 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 1619347192

Sam's East, Inc.'s National Provider Identifier is 1619347192, issued on Sep 28, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Woodstock, GA. The record was last updated on Sep 28, 2015.