NPI 1154412724

Sam's Club Optical

Organisation Eyewear Supplier Granville, WV

Practice location

Address: 5045 University Town Center Dr, Granville, WV 26501-2267
Phone: (304) 598-3169
Fax: (304) 598-3186
Mailing address: 1 Customer Dr Ms 0445, Bentonville, AR 72716-0445

Authorised official

Name: Kimberly Canonic
Title: Sr. Director
Phone: (480) 853-0515

Registered specialties (2)

Eyewear Supplier Primary

Suppliers Taxonomy 332H00000X

Other Eyewear Supplier providers in West Virginia →

Optician

Eye and Vision Services Providers Taxonomy 156FX1800X

Other Technician/Technologist providers in West Virginia →

Registry record

NPI: 1154412724
Entity type: Organization
NPI issued: 27 Sep 2006
Record last updated: 29 Sep 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.