Organization · Type 2 NPI

Sam's West, Inc.

Eyewear Supplier · Conway, AR

NPI number 1639620099 Active

Practice location

1250 South Amity Rd
Conway, AR 72032

Call (501) 205-7454 Map

Fax (501) 504-2576

Mailing address

702 SW 8th St
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Optician	156FX1800X	None listed
Eyewear Supplier Primary	332H00000X	None listed

Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Other eyewear supplier providers in Conway

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NPI record

NPI: 1639620099
Entity type: Organization (Type 2)
Issued: Oct 20, 2016
Last updated: Oct 20, 2016
Status: Active
Subpart: Yes of Wal-Mart Stores, Inc

Other names

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Sam's Club Vision Center 30-4749 · doing business as

Authorized official

Laura Levine
Dir. Healthcare Contracting
(479) 204-8550

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1639620099

Sam's West, Inc.'s National Provider Identifier is 1639620099, issued on Oct 20, 2016. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Conway, AR. The record was last updated on Oct 20, 2016.