MEDICARE: BJS 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	156FX1800X	Optician

General Provider Information

NPI Number	:	1881545895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BJS 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	:	1021 IKEA WAY
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-0043
Country	:	US
Telephone Number	:	972-812-0293
Fax Number	:	972-730-9237

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

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “BJS WHOLESALE CLUB INC ” Practice Location

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