| Organization Name: | SAM'S CLUB OPTICAL |
| NPI Number: | 1689707804 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NORMA B SMITH (MPI ASSOCIATE) |
| Mailing Address: | 3440 Ross Clark Cir Dothan |
| State: | AL US |
| Postal Code: | 363032525 |
| Phone Number: | 3346715005 |
| Fax Number: | |
| NPI Enumeration Date: | 03/14/2007 |
| NPI Last Update Date: | 07/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |