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Contact Information

SAM'S CLUB OPTICAL
665 MALL DR
PORTAGE, MI49024-2879
 Phone: 269-323-2700
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Eyewear Supplier

332H00000X 87 All Other Suppliers
 

Optician

156FX1800X 96[5] Optician
Indicates primary specialty

NPI Profile & details for SAM'S CLUB OPTICAL

NPI # 1932200896
LBN Legal business name SAM'S CLUB OPTICAL
Authorized official LINDA EPPERSON - (NPI COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/25/2006
Last updated 09/11/2025 - About 9 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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