NPIMap

Organization Active NPI

Sam'S West, Inc

  • Eyewear Supplier
  • Ankeny, IA
National Provider Identifier
1366835514
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
SAM'S WEST, INC
Practice address
4625 SE Delaware Ave
Ankeny, IA 50021-9351
Phone
(515) 559-1995
Fax
(515) 559-1996
NPI assigned
Mar 12, 2015
Organization subpart
Yes
Parent organization
WAL-MART STORES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Authorized official

Name
Deb Lauver
Title
Specialist Plan Enrollment
Phone
(479) 258-2115

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

4625 SE Delaware Ave
Ankeny, IA 50021-9351

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445
Phone (479) 258-2115

Other names 1

  • Sam's Club Vision Center 30-6979 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network281 organizations share this tax ID, including this one
Part of
Walmart Pharmact

Organizations with this tax ID in the same state 11

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

Locations

4625 SE Delaware Ave
Ankeny, IA 50021
Phone (515) 559-1995

NPI Registry JSON

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1366835514",
    "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": "479-258-2115",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 SE DELAWARE AVE",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500219351",
            "telephone_number": "515-559-1995",
            "fax_number": "515-559-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM'S WEST, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAL-MART STORES, INC",
        "enumeration_date": "2015-03-12",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "LAUVER",
        "authorized_official_first_name": "DEB",
        "authorized_official_title_or_position": "SPECIALIST PLAN ENROLLMENT",
        "authorized_official_telephone_number": "479-258-2115"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sam's Club Vision Center 30-6979",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.