MEDICARE: BJ'S WHOLESALE CLUB INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1689529323
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BJ'S WHOLESALE CLUB INC.

Provider Business Mailing Address
First Line	:	350 CAMPUS DR
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-3082
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5857 STATE RTE 100 E
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164
Country	:	US
Telephone Number	:	386-346-2013
Fax Number	:

Authorized Official
Title or Position	:	OPTICAL OPERATIONS MANAGER
Name	:	JESSICA WATSON
Credential	:
Telephone Number	:	774-512-5206

Provider Enumeration Date	:	02/27/2026
Last Update Date	:	02/27/2026

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