SAM'S WEST, INC (NPI# 1366835514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366835514 |
| Entity Type | Organization |
| Organization Name | SAM'S WEST, INC |
| Other Organization Name | SAM'S CLUB VISION CENTER 30-6979 |
| Practice Address |
4625 Se Delaware Ave Ankeny IA 50021-9351 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 5155591995 |
| Practice Fax Number | 5155591996 |
| Mailing Telephone | 4792582115 |
| Mailing Fax Number | 4792774331 |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2015-03-12 |
| Authorized Official Name | DEB LAUVER (SPECIALIST PLAN ENROLLMENT) |
| Authorized Official Telephone | 4792582115 |
| Is Organization Subpart | Y |
| Parent Organization Name | WAL-MART STORES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers | ||
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Sam's Club Vision Center 30-6979 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407251630 | Sam's West, Inc | Technician/Technologist | 601 S Placentia Ave, Fullerton, CA 92831 | 2014-10-30 |
| 1275945255 | Sam's West, Inc | Technician/Technologist | 1050 Ogden Ave, Montgomery, IL 60538-5404 | 2014-05-27 |
| 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 |
4625 SE DELAWARE AVE |
| City | ANKENY |
| State | IA |
| Zip Code | 50021-9351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881826220 | Erin Marie Christensen | Pharmacist | 4625 Se Delaware Ave, Ankeny, IA 50021-9351 | 2009-08-19 |
| 1992320618 | Keri Lynn Michel | Pharmacist | 4625 Se Delaware Ave, Ankeny, IA 50021-9351 | 2020-06-09 |
| 1245623016 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 4625 Se Delaware Ave, Ankeny, IA 50021-9351 | 2015-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851856298 | Amy Jo Coenen | Physical Therapy Assistant | 710 East 1st Street, Ankeny, IA 50021 | 2019-02-08 |
| 1073006847 | Kylie Linn Shear | Behavior Technician | 1555 Se Deleware, Ankeny, IA 50021 | 2018-06-07 |
| 1174013445 | Maxwell Sando | Psychologist | 250 Ne 41st Unit 260, Ankeny, IA 50021 | 2018-05-12 |
| 1235638537 | Bria Lynn Colyer | Massage Therapist | 104 Ne 46th Lane Number 9, Ankeny, IA 50021 | 2018-02-02 |
| 1134485998 | Leslie R. Fenimore | Nurse Practitioner | 800 1st Avenue, Mercy North Clinic, Ankeny, IA 50021 | 2012-04-05 |
| 1063713667 | Lori Eisbrener | Counselor | 2525 N Ankeny Blvd, Ste 113, Ankeny, IA 50021 | 2010-11-12 |
| 1679899355 | Rcf Youth Project | Community/Behavioral Health | 738 Ne 8th Street, Ankeny, IA 50021 | 2010-04-20 |
| 1437320595 | Iowa Sleep Disorders Center, P.C. | Clinic/Center | 400 Se Delaware Ave, Ankeny, IA 50021 | 2008-03-17 |
| 1558553891 | Center for Interpersonal Effectiveness, PC | Community/Behavioral Health | 2525 N. Ankeny Blvd., Ste 113, Ankeny, IA 50021 | 2007-08-10 |
| 1295850196 | Stacy Burns Young | Speech-Language Pathologist | 301 Ne Trilein, Suite 4, Ankeny, IA 50021 | 2007-03-20 |
| Find all providers in zip 50021 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518123959 | Visualeyes,inc. | Eyewear Supplier (Equipment, not the service) | 324 S Ankeny Blvd, Ankeny, IA 50023-3127 | 2008-08-05 |
| 1992914857 | Real Optics Inc | Eyewear Supplier (Equipment, not the service) | 119 N Ankeny Blvd, Ankeny, IA 50023-1708 | 2007-05-21 |
| 1437557402 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 2409 Se Delaware Ave, Ankeny, IA 50021-4553 | 2014-12-08 |
| 1922159318 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 2135 Se Delaware Ave, Ankeny, IA 50021-4592 | 2007-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538711775 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 440 S 68th St Ste 107-108, West Des Moines, IA 50266-8431 | 2019-07-09 |
| 1588220974 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3500 Dodge St Ste 110b, Dubuque, IA 52003-5208 | 2019-05-12 |
| 1215593686 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2927 Hamilton Blvd, Sioux City, IA 51104-2405 | 2019-05-11 |
| 1104482579 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3570 4th St Sw Ste 400, Mason City, IA 50401-1550 | 2019-05-11 |
| 1902382773 | Vision4less | Eyewear Supplier (Equipment, not the service) | 1810 N Coral St, Coralville, IA 52241-7606 | 2018-07-16 |
| 1487147963 | Mcfarland Clinic, PC | Eyewear Supplier (Equipment, not the service) | 3500 University Blvd., Suite 1001, Ames, IA 50010 | 2018-06-11 |
| 1043760093 | Hw Holdings | Eyewear Supplier (Equipment, not the service) | 2027 Crossroads Blvd, Waterloo, IA 50702-4405 | 2016-10-13 |
| 1053861005 | Hw Holdings | Eyewear Supplier (Equipment, not the service) | 1035 Lawrence St Ste 106, Burlington, IA 52601-1549 | 2016-10-13 |
| 1659705051 | Glasses Connect Inc. | Eyewear Supplier (Equipment, not the service) | 5801 Se 24th St Unit 75, Des Moines, IA 50320-4704 | 2013-08-21 |
| 1639475197 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 4444 1st Ave Ne Ste 575, Cedar Rapids, IA 52402 | 2011-02-01 |
| Find all providers with the same taxonomy | ||||
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| 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.