SAM'S WEST, INC. (NPI# 1306863691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306863691 |
| Entity Type | Organization |
| Organization Name | SAM'S WEST, INC. |
| Other Organization Name | SAMS PHARMACY |
| Practice Address |
6570 Grand Ave Gurnee IL 60031-1621 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 8478558620 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2019-08-27 |
| Authorized Official Name | SARAH LITTLE (DIRECTOR- PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 4792772500 |
| Is Organization Subpart | Y |
| Parent Organization Name | WALMART INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
54014456 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1473052 | 01 |
| Other Name | Type Code |
|---|---|
| Sam's Pharmacy 10-8184 | Doing Business As Name - Organization |
| SAMS PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790223006 | Sam's West, Inc. | Technician/Technologist | 1517 Gene George Blvd, Springdale, AR 72762 | 2017-02-07 |
| 1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1922559343 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1250 Sourth Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1851790810 | Sam's West, Inc. | Technician/Technologist | 9851 S 71st Plaza, Papillion, NE 68133 | 2014-08-15 |
| 1922428721 | Sam's West, Inc. | Technician/Technologist | 3084 N. Maize Road, Witchita, KS 67205 | 2014-04-18 |
| 1518476704 | Sam's West, Inc. | Eyewear Supplier (Equipment, not the service) | 7100 Arroyo Crossing Pkwy, Las Vegas, NV 89113-4057 | 2017-09-20 |
| 1386182640 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1517 Gene George Blvd, Springdale, AR 72762 | 2017-02-07 |
| 1558805465 | Sam's West, Inc. | Technician/Technologist | 5940 Promenade Pkwy, Castle Rock, CO 80108 | 2016-12-12 |
| 1285092577 | Sam's West, Inc. | Technician/Technologist | 1200 S Hover St, Longmont, CO 80501-7902 | 2016-02-02 |
| 1003092438 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 7100 Arroyo Crossing Pkwy, Las Vegas, NV 89113-4057 | 2008-01-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SAM'S WEST, INC. | 702 Sw 8th St, Bentonville, AR 72716 |
| Colorado Business Entities | SAM'S WEST, INC. | 708 Sw 8th Street, Bentonville, AR 72716 |
| Iowa Business Entities | SAM'S WEST, INC. | 708 Sw 8th Street, Bentonville, AR 72716 |
| Massachusetts Corporations | SAM'S WEST, INC. | 702 Sw 8th Street, Bentonville, AR 72716 |
| Washington State Corporations | SAM'S WEST, INC. | 708 Sw 8th Street, Bentonville, AR 72716 |
| Vermont Business Registrations | SAM'S WEST, INC. | 702 Sw 8th Street, Bentonville, AR 72716 |
| Street Address |
6570 GRAND AVE |
| City | GURNEE |
| State | IL |
| Zip Code | 60031-1621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062800 | Anna Majerczak | Pharmacist | 6570 Grand Ave, Gurnee, IL 60031-1621 | 2020-10-27 |
| 1477600518 | Daniel Nast Jr. | Optometrist | 6570 Grand Ave, Co Sams Club, Gurnee, IL 60031 | 2007-01-04 |
| 1124129887 | Sams Club Optical | Technician/Technologist | 6570 Grand Ave, Gurnee, IL 60031-1621 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881174720 | Rockelle Waggoner | Behavioral Analyst | 489 Tanglewood Dr, Gurnee, IL 60031 | 2018-08-20 |
| 1316434376 | Lake County Internal Medicine Assoc LLC | Non-Pharmacy Dispensing Site | 15 Tower Ct., Ste 190, Gurnee, IL 60031 | 2018-04-16 |
| 1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
| 1578081550 | Northshore Medical Consultants, Ltd | Family Medicine | 1425 Hunt Club Rd. #302, Gurnee, IL 60031 | 2017-08-30 |
| 1336678739 | Sarah Beth Fugelseth | Nurse Practitioner | 1445 N Hunt Club Rd Ste 304, Gurnee, IL 60031 | 2017-06-08 |
| 1174079867 | Lifecarepros, LLC | In Home Supportive Care | 223 North Route 21, Gurnee, IL 60031 | 2016-09-01 |
| 1740733195 | Ryan Lee Winslow | Chiropractor | 6021 Washington St, Unit B, Gurnee, IL 60031 | 2016-08-02 |
| 1891129599 | Smart Scan Mri, LLC | Clinic/Center | 350 S. Greenleaf, Suite 401, Gurnee, IL 60031 | 2013-08-29 |
| 1568720076 | Yudelca Romano | Genetic Counselor, MS | 1125 Tri State Parkway, Gurnee, IL 60031 | 2012-05-03 |
| 1558637348 | Laura E Novak | Social Worker | 4212 Old Grand Avenue, Gurnne, IL 60031 | 2012-03-27 |
| Find all providers in zip 60031 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164437331 | Walgreen Co | Pharmacy | 7501 Grand Ave, Gurnee, IL 60031-1551 | 2006-07-29 |
| 1487085288 | Roundys Supermarkets Inc | Pharmacy | 6655 Grand Ave, Gurnee, IL 60031-5274 | 2013-12-03 |
| 1801144951 | Medcare Pharmacy Inc | Pharmacy | 15 Tower Ct, Suite 195, Gurnee, IL 60031-3336 | 2012-08-21 |
| 1588996136 | Best Vital Rx Inc | Pharmacy | 15 Tower Ct Ste 195, Gurnee, IL 60031-3340 | 2010-02-08 |
| 1760684088 | Rx Tower Pharmacy, Ltd. | Pharmacy | 15 Tower Ct, Suite 195, Gurnee, IL 60031-3336 | 2007-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538582 | Wilmington Pharmacy LLC | Pharmacy | 600 W Baltimore St, Wilmington, IL 60481-1281 | 2020-11-03 |
| 1952909632 | Cordant Pharmacy Illinois, LLC | Pharmacy | 8623 W Bryn Mawr Ave Ste 504, Chicago, IL 60631-3525 | 2020-10-14 |
| 1386242352 | Letitride, Inc. | Pharmacy | 501 W Oak Street, Fairbury, IL 61739 | 2020-10-13 |
| 1699389890 | J2sb LLC | Pharmacy | 398 W Army Trail Rd Ste 120, Bloomingdale, IL 60108-2398 | 2020-09-04 |
| 1891308045 | Apotheco Pharmacy Lincoln Park LLC | Pharmacy | 2140 N Halsted St, Chicago, IL 60614-4385 | 2020-08-27 |
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1710599485 | Costco Wholesale Corporation | Pharmacy | 16261 S Boulevard Pl, Plainfield, IL 60586-4400 | 2020-08-23 |
| 1982212635 | Grand Pharmacy LLC | Pharmacy | 229 W Grand Ave Ste F, Bensenville, IL 60106-3365 | 2020-07-20 |
| 1871110254 | Illini Clinic Pharmacy Inc | Pharmacy | 103 N Prospect St, Cambridge, IL 61238-1148 | 2020-07-01 |
| 1831716745 | The Project of The Quad Cities | Pharmacy | 1701 River Dr Ste 106, Moline, IL 61265-1384 | 2020-06-26 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SAM'S WEST, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.