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 1649379173

Sam's Club Optical is an Optician in Gaithersburg, Maryland. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2

Practice location Address checks out

610 N Frederick Ave
Gaithersburg, MD 20877-2527
Phone: (240) 631-7716
Fax: (240) 631-7819
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 number1649379173
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Canonic — Sr. Director · (479) 371-1168
Other names Sam'S Club Optical 30-6653
NPI enumeratedSeptember 21, 2006
Last updated in NPPESSeptember 29, 2025
Certification dateSeptember 29, 2025
Mailing address1 Customer Dr, Ms 0445, Bentonville, AR 72716-0445

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