Organization · Type 2 NPI

Sam's West Inc

Eyewear Supplier · Glen Carbon, IL

NPI number 1871930289 Active

Practice location

5 Illini Dr
Glen Carbon, IL 62034-3929

Call (618) 692-7568 Map

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.

6 other providers at this address

Other eyewear supplier providers in Glen Carbon

Wal-Mart Stores, IncEyewear Supplier Glen Carbon, IL NPI 1235210238

See all in Glen Carbon →

NPI record

NPI: 1871930289
Entity type: Organization (Type 2)
Issued: May 24, 2013
Last updated: May 24, 2013
Status: Active
Subpart: Yes of Wal-Mart Stores Inc

Other names

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Sam's Vision Center 30-4878 · doing business as

Authorized official

Amy Powers
Specialist, Plan Enrollment
(479) 204-0709

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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 1871930289

Sam's West Inc's National Provider Identifier is 1871930289, issued on May 24, 2013. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Glen Carbon, IL. The record was last updated on May 24, 2013.