Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sam's Club Optical

Organization Optician · NPI 1154412724

Sam's Club Optical is an Optician in Granville, West Virginia. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2

Practice location Address checks out

5045 University Town Center Dr
Granville, WV 26501-2267
Phone: (304) 598-3169
Fax: (304) 598-3186
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Eyewear Supplier (primary) Taxonomy 332H00000X
Optician Taxonomy 156FX1800X

Record details

NPI number1154412724
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Canonic — Sr. Director · (480) 853-0515
Other names Sam'S Club Optical 30-4936
NPI enumeratedSeptember 27, 2006
Last updated in NPPESSeptember 29, 2025
Certification dateSeptember 29, 2025
Mailing address1 Customer Dr, Ms 0445, Bentonville, AR 72716-0445