NPIMap

Organization Active NPI

Sam's West, Inc.

Doing business as Sam's Pharmacy 10-4956

  • Community/Retail Pharmacy
  • Tempe, AZ
National Provider Identifier
1235938416
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SAM'S WEST, INC.
Doing business as
Sam's Pharmacy 10-4956
Practice address
2080 E Rio Salado Pkwy
Tempe, AZ 85288-4840
Phone
(479) 371-2827
NPI assigned
Mar 11, 2025
Last updated
Mar 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kimberly Canonic
Title
Senior Director
Phone
(480) 277-6348

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2080 E Rio Salado Pkwy
Tempe, AZ 85288-4840

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445
Phone (479) 371-2827

Other names 1

  • Sam's Pharmacy 10-4956 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130808000006 AZ Part B Supplier - Mass Immunization (Roster Biller Only) 1850412321 12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Avondale, AZ; Yuma, AZ; Tucson, AZ; Tempe, AZ; Surprise, AZ; Phoenix, AZ; Gilbert, AZ; Flagstaff, AZ…
O20250912002563 AZ DME Supplier - Pharmacy 1850412321 Practice locations: Tempe, AZ

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Sam's Pharmacy 10-49562080 E Rio Salado Pkwy, Tempe, AZ 85288-4840(602) 735-3951 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Ostomy Supplies|Prosthetic Lenses: Conventional Eyeglasses|Enteral Nutrients|Surgical Dressings Accepts assignmentParticipating since Nov 1, 2018

National Provider Directory

National Provider Directory
Tax ID family
Ability Network283 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations (25 of 104)

1074 N Muldoon Rd
Anchorage, AK 99504
Phone (907) 677-7050

1074 N Muldoon Rd
#106602
Anchorage, AK 99504
Phone (907) 667-7050

8801 Old Seward Hwy
Anchorage, AK 99515
Phone (907) 522-2333

8801 Old Seward Hwy
#106601
Anchorage, AK 99515
Phone (907) 644-0880

3500 SE Club Blvd
#10
Bentonville, AR 72712
Phone (479) 621-0283

1250 S Amity Rd
Conway, AR 72032
Phone (501) 205-7460

3081 N Highway 112
Fayetteville, AR 72704
Phone (479) 527-0100

7700 Rogers Ave
#10
Fort Smith, AR 72903
Phone (479) 484-8008

1368 Higdon Ferry Rd
Hot Springs, AR 71913
Phone (501) 625-7212

900 S Bowman Rd
Little Rock, AR 72211
Phone (501) 219-0283

600 Highway 95
Ste 200
Bullhead City, AZ 86429
Phone (928) 754-3900

2425 E Florence Blvd
Casa Grande, AZ 85194
Phone (520) 413-6831

1375 S Arizona Ave
Chandler, AZ 85286
Phone (480) 364-1568

700 N 54th St
Chandler, AZ 85226
Phone (480) 436-3445

1525 W Bell Rd
Phoenix, AZ 85023
Phone (602) 439-9867

5757 E State Route 69
Prescott Valley, AZ 86314
Phone (928) 778-0364

15255 N Northsight Blvd
#106241
Scottsdale, AZ 85260
Phone (480) 998-8302

2080 E Rio Salado Pkwy
Tempe, AZ 85288
Phone (480) 606-1806

17835 Gale Ave
City of Industry, CA 91748
Phone (626) 912-2010

1225 Concord Ave
Concord, CA 94520
Phone (925) 349-2472

4901 Santa Anita Ave
El Monte, CA 91731
Phone (626) 652-6915

17099 Brookhurst St
Fountain Valley, CA 92708
Phone (714) 965-0958

1399 W Artesia Blvd
Gardena, CA 90248
Phone (310) 532-3489

40500 Murrieta Hot Springs Rd
Murrieta, CA 92563
Phone (951) 600-9191

3360 El Camino Ave
Sacramento, CA 95821
Phone (916) 487-8242

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1235938416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445",
            "telephone_number": "479-371-2827",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 E RIO SALADO PKWY",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852884840",
            "telephone_number": "479-371-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM'S WEST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "CANONIC",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR",
        "authorized_official_telephone_number": "480-277-6348"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sam's Pharmacy 10-4956",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.