Sam'S Club Optical 30-8128

LBN: Sam'S Club Optical
Sam'S Club Optical 30-8128 is an health care organization with primary practice located at 4100 W Willow Knolls Dr , Peoria IL 61615-4405. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optician, Suppliers / Eyewear Supplier (Equipment, not the service). Eye and Vision Services Providers / Optician is the primary health care specialty. Sam'S Club Optical can be contacted via phone (309) 691-4545, or through Epperson, Linda M. via phone (316) 788-5580.

Contact Information

Primary practice address
4100 W Willow Knolls Dr Peoria IL 61615-4405
Phone: (309) 691-4545
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Epperson, Linda M.
Phone: (316) 788-5580

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X

Profile Details

NPI number 1225125925
LBN Legal business name Sam'S Club Optical
DBA Doing business as Sam'S Club Optical 30-8128
Authorized official Epperson, Linda M.
Entity Organization
Organization subpart 1 No
Enumeration date Oct 6th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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