SAM'S WEST, INC (NPI# 1407251630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407251630 |
| Entity Type | Organization |
| Organization Name | SAM'S WEST, INC |
| Other Organization Name | SAM'S CLUB VISION CENTER 30-6616 |
| Practice Address |
601 S Placentia Ave Fullerton CA 92831 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 4782582115 |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2014-10-30 |
| 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 30-6616 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366835514 | Sam's West, Inc | Technician/Technologist | 4625 Se Delaware Ave, Ankeny, IA 50021-9351 | 2015-03-12 |
| 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 |
601 S PLACENTIA AVE |
| City | FULLERTON |
| State | CA |
| Zip Code | 92831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982169280 | Jennifer Ann Carroll | Counselor | 2246 N. State College Blvd, Fullerton, CA 92831 | 2019-01-31 |
| 1043733736 | Jimmy K Bhatt | Dentist | 1126 E Commonweath Ave, Fullerton, CA 92831 | 2017-07-25 |
| 1447625090 | Kairos Management | Assisted Living Facility | 1621 E. Chapman Ave, Fullerton, CA 92831 | 2015-12-08 |
| 1114361813 | Teresa Kyu Thin Khoo | Internal Medicine | 1907 Deerpark Dr Apt 546, Fullerton, CA 92831 | 2013-04-24 |
| 1699020586 | Julia A Bock | Occupational Therapy Assistant | 1240 N Frances Avenue, Fullerton, CA 92831 | 2012-07-17 |
| 1649566225 | The Center for The Treatment of Addiction | Preferred Provider Organization | 104 N. Raymond Ave., A-2, Fullerton, CA 92831 | 2011-06-22 |
| 1366746877 | Leticia Vallejo | Rehabilitation Practitioner | 801 E.chapman Ave, Fullerton, CA 92831 | 2010-12-28 |
| 1083916860 | Angelica Victoria Norman | Counselor | 801 East Chapman Suite 203, Fullerton, CA 92831 | 2010-11-30 |
| 1457683237 | The Paradise | Home Delivered Meals | 659 S Sate College Blvd., Ste. 51, Fullerton, CA 92831 | 2010-02-04 |
| 1639405525 | Charles Yun | Acupuncturist | 2008 N. Deerpark Drive, Apt. # 314, Fullerton, CA 92831 | 2009-10-27 |
| Find all providers in zip 92831 | ||||
| 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 |
|---|---|---|---|---|
| 1144371170 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 1893 Malvern Ave, Fullerton, CA 92833-2403 | 2007-01-16 |
| 1275922742 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 900 S Harbor Blvd, Fullerton, CA 92832-3025 | 2015-01-21 |
| 1467884882 | Atheni Yang Dba Fullerton Eye Center Optical | Eyewear Supplier (Equipment, not the service) | 1321 N Harbor Blvd, Suite 301, Fullerton, CA 92835-4124 | 2013-08-08 |
| 1154664985 | James N Berbos Dba Fullerton Eye Center Optical | Eyewear Supplier (Equipment, not the service) | 1321 N Harbor Blvd, Suite 300, Fullerton, CA 92835-4124 | 2013-03-29 |
| 1841542271 | William D. Mosier Md | Eyewear Supplier (Equipment, not the service) | 265 Laguna Rd, Fullerton, CA 92835-2515 | 2012-10-09 |
| 1801065578 | John D. Zdral, M.d., Inc. | Eyewear Supplier (Equipment, not the service) | 301 W Bastanchury Rd, Suite 10, Fullerton, CA 92835-3419 | 2008-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902488 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 300 E Colorado Blvd Ste 128, Pasadena, CA 91101-2267 | 2020-11-02 |
| 1700485562 | Vision Faire Optometry, Inc. A Professional Optometric Corporation | Eyewear Supplier (Equipment, not the service) | 4213 Dale Rd Ste A-2, Modesto, CA 95356-8505 | 2020-10-22 |
| 1154929859 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5500 W Sunset Blvd, Los Angeles, CA 90028 | 2020-10-14 |
| 1295333029 | Tiger & Lion Inc | Eyewear Supplier (Equipment, not the service) | 1251 S Beach Blvd Ste F, La Habra, CA 90631-6397 | 2020-10-14 |
| 1245866565 | Joshua Adolfo Velasquez | Eyewear Supplier (Equipment, not the service) | 849 N Ridgewood Pl, Los Angeles, CA 90038-4302 | 2020-03-18 |
| 1952948424 | Luvc LLC | Eyewear Supplier (Equipment, not the service) | 2223 Carlton Ave, Pomona, CA 91768-1015 | 2019-12-04 |
| 1568011377 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 6440 E. Pacific Coast Highway, Space B-165, Long Beach, CA 90803 | 2019-09-05 |
| 1184270746 | Nueyes Technologies Inc | Eyewear Supplier (Equipment, not the service) | 120 Newport Center Dr # 232, Newport Beach, CA 92660-6916 | 2019-08-09 |
| 1881248102 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 12182 1/2 Ventura Blvd, Studio City, CA 91604-2517 | 2019-07-25 |
| 1730732363 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 1628 Redwood Hwy Spc D017, Corte Madera, CA 94925-1248 | 2019-07-23 |
| 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.