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SAM'S CLUB OPTICAL
NPI 1124123914
Eyewear Supplier in Myrtle Beach, SC

Active since September 14, 2006
1946 10TH AVENUE NORTH, MYRTLE BEACH, SC 29577(843) 946-9521(843) 916-1481 Get Directions Write a Review

NPPES record last updated: October 14, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Sam's Club Optical NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAM'S CLUB OPTICAL (NPI 1124123914), doing business as Sam's Club Optical 30-6353, is a healthcare organization registered as an eyewear supplier in Myrtle Beach, South Carolina and active in the NPI registry since September 2006. The organization lists Kimberly Canonic, Sr. Director, as its authorized official.

NPPES Registry Identity

NPI1124123914
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSAM'S CLUB OPTICAL
Location Address1946 10TH AVENUE NORTHMyrtle Beach, SC 29577-5624
Mailing Address1 Customer Dr, Ms 0445Bentonville, AR 72716-0445
Phone(843) 946-9521
Fax(843) 916-1481
Organization SubpartNo
Authorized OfficialKimberly CanonicSr. Director · (479) 371-1168
Enumeration DateSeptember 14, 2006
Last NPPES UpdateOctober 14, 20252 updates tracked since enumeration
NPPES CertifiedOctober 14, 2025
✔ NPI 1124123914 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Also ListedTechnician/Technologist · OpticianTaxonomy 156FX1800X
1946 10TH AVENUE NORTH, Myrtle Beach, SC 29577
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Other Names 1

Doing Business AsSam's Club Optical 30-6353

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Sam's Club Pharmacy 10-6353 carries, from the Medicare DMEPOS supplier directory.

Sam's Club Pharmacy 10-6353

DMEPOS supplier · Myrtle Beach, SCOperated by Sam's East, Inc.
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Does not accept Medicare assignment

Sam's Club Pharmacy 10-6353 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20513951
Medicare Participant SinceMay 15, 2013
Supplier Location1946 10th Ave NMyrtle Beach, SC 29577
Phone(843) 445-7179
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sam's Club Optical's NPI number?

The NPI number for Sam's Club Optical is 1124123914. It was assigned to this organization in the NPPES registry on September 14, 2006. The provider is doing business as Sam's Club Optical 30-6353.

Where is Sam's Club Optical located?

Sam's Club Optical is located at 1946 10th Avenue North, Myrtle Beach, SC 29577. The listed phone number is (843) 946-9521.

What is Sam's Club Optical's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Does Sam's Club Optical accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Sam's Club Pharmacy 10-6353 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

What insurance does Sam's Club Optical accept?

Health plans from Blue Cross and Blue Shield of Louisiana list Sam's Club Optical as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sam's Club Optical was last updated on October 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.