SAM'S WEST INC (NPI# 1871930289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871930289 |
| Entity Type | Organization |
| Organization Name | SAM'S WEST INC |
| Other Organization Name | SAM'S VISION CENTER 30-4878 |
| Practice Address |
5 Illini Dr Glen Carbon IL 62034-3929 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 6186927568 |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2013-05-24 |
| Authorized Official Name | AMY POWERS (SPECIALIST, PLAN ENROLLMENT) |
| Authorized Official Telephone | 4792040709 |
| 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 Vision Center 30-4878 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952543761 | Sam's West Inc | Durable Medical Equipment & Medical Supplies | 4901 Santa Anita Ave, El Monte, CA 91731-1415 | 2009-03-26 |
| 1306087820 | Sam's West Inc | Durable Medical Equipment & Medical Supplies | 2709 Walton Way, Marion, IL 62959-4901 | 2009-03-12 |
| 1679718894 | Sam's West Inc | Pharmacy | 16573 W Bell Rd, Surprise, AZ 85374-9892 | 2008-12-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Sam's West Inc. | 160 Mine Lake Ct Ste 200, Raleigh, NC 27615-6417 |
| Virginia Business Entities | Sam's West Inc. | 702 Sw 8th St, Bentonville, Arkansas 72716-6209 |
| Street Address |
5 ILLINI DR |
| City | GLEN CARBON |
| State | IL |
| Zip Code | 62034-3929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083938245 | Gregory Anthony Cochran | Pharmacist | 5 Illini Dr, Glen Carbon, IL 62034-3927 | 2010-03-17 |
| 1003158676 | Sams West Inc | Pharmacy | 5 Illini Dr, Glen Carbon, IL 62034-3929 | 2013-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740787795 | Kaleena Galletta | Nurse Practitioner | 4273 S., Il - 159, Glen Carbon, IL 62034 | 2018-04-06 |
| 1871092502 | Andrea Lee Sullivan | Dentist | 3024 South Il-159, Glen Carbon, IL 62034 | 2018-02-08 |
| 1417464918 | Stages Health & Wellness, LLC | Nurse Practitioner | 14 Crabapple Lane, Glen Carbon, IL 62034 | 2018-01-05 |
| 1700300498 | Michael Jay Arnold | Dentist | 3024 Il-159, Glen Carbon, IL 62034 | 2017-08-03 |
| 1679024228 | 360 Body Wellness Inc | Internal Medicine | 3407 Il State Route 157, Glen Carbon, IL 62034 | 2016-10-19 |
| 1346621505 | Stephanie N Lorts | Pediatrics | 4804 South State Route 159, Glen Carbon, IL 62034 | 2015-06-13 |
| 1205110111 | James Allan Staley | Pharmacist | #2 Cottonwood Rd, Glen Carbon, IL 62034 | 2011-10-11 |
| 1215224357 | Angela Eleni Kioultzopoulos | Speech-Language Pathologist | 7a Ginger Creek Village Dr., Glen Carbon, IL 62034 | 2011-07-08 |
| 1922320795 | Meridian Village Association | Skilled Nursing Facility | 27 Auerbach Place, Glen Carbon, IL 62034 | 2010-02-22 |
| 1679728356 | Erin Kathleen Immken | Counselor | 98 Junction Drive West, Suite 6, Glen Carbon, IL 62034 | 2008-11-24 |
| Find all providers in zip 62034 | ||||
| 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 |
|---|---|---|---|---|
| 1174138168 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1550 W Lane Rd, Machesney Park, IL 61115-1903 | 2020-09-15 |
| 1588279566 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1190 S Randall Rd Ste 104, Elgin, IL 60123-4110 | 2020-09-15 |
| 1972129294 | Luxottica Retail North America, Inc | Eyewear Supplier (Equipment, not the service) | 900 W North Ave, Chicago, IL 60642-2506 | 2020-06-23 |
| 1710512801 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 9940 Rt 47, Huntley, IL 60142 | 2020-03-09 |
| 1710512488 | Glasses On Oak St | Eyewear Supplier (Equipment, not the service) | 900 N Michigan Ave Fl 5, Chicago, IL 60611-1542 | 2020-03-03 |
| 1861026890 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 5300 Northwest Hwy, Crystal Lake, IL 60014-8072 | 2020-02-28 |
| 1952935181 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 4999 Old Orchard Ctr Ste J4, Skokie, IL 60077-1450 | 2020-02-26 |
| 1194355917 | Fr Vision 360, Inc. | Eyewear Supplier (Equipment, not the service) | 111 E Morton Ave, Jacksonville, IL 62650-3059 | 2020-01-21 |
| 1114567443 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 6215 Northwest Hwy, Crystal Lake, IL 60014-7932 | 2020-01-15 |
| 1841833399 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | Milwaukee Ave & E Towline Rd #e1600, Vernon Hills, IL 60061 | 2019-10-28 |
| Find all providers with the same taxonomy | ||||
| City | GLEN CARBON |
| Zip Code | 62034 |
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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.