MEDICARE: SAM'S CLUB OPTICAL

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
2	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1902987308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAM'S CLUB OPTICAL

Provider Business Mailing Address
First Line	:	702 SW 8TH STREET
Second Line	:
City	:	BENTONVILLE
State	:	AR
Zip	:	72716-0235
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 CONLEY RD
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65201-6465
Country	:	US
Telephone Number	:	573-875-2979
Fax Number	:

Authorized Official
Title or Position	:	NPI COORDINATOR
Name	:	LINDA M. EPPERSON
Credential	:
Telephone Number	:	316-788-5580

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	09/11/2025

Similar Medicare Providers

1073270351 — YA'LITA WILLIAMS THOMPSON LCSW
Practice Location Address:

115 CONLEY RD # 1110
COLUMBIA, MO
65201-6465

Practice Phone: 573-485-5343
Practice Fax: 573-943-0179

1598782831 — SAMS EAST INC
Practice Location Address:

101 CONLEY RD
COLUMBIA, MO
65201-6465

Practice Phone: 573-875-1095
Practice Fax:

1699024695 — DR. JASON M CLARK O.D.
Practice Location Address:

101 CONLEY RD
COLUMBIA, MO
65201-6465

Practice Phone: 573-875-1126
Practice Fax:

1710383435 — EPOCH - CENTRAL MISSOURI LIMITED LIABILITY COMPANY
Practice Location Address:

2900 TRIMBLE RD.
COLUMBIA, MO
65201-6465

Practice Phone: 573-818-3067
Practice Fax:

1679308605 — JANIA AYRIE MOORE
Practice Location Address:

115 CONLEY RD # 110
COLUMBIA, MO
65201-6465

Practice Phone: 314-327-2005
Practice Fax:

1639763147 — MS. AMBER LIPONOGA LCSW
Practice Location Address:

1500 FELLOWS PL APT 3C
COLUMBIA, MO
65201-8529

Practice Phone: 573-823-2842
Practice Fax:

Directions to “SAM'S CLUB OPTICAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.