Organization · NPI-2

Sam'S West, INC.

Technician/Technologist, Optician · Tempe, AZ

NPI number1023800950

StatusActive

Last updated in NPPESMay 19, 2025

Details

NPI: 1023800950
Entity type: Organization (NPI-2)
Legal business name: Sam'S West, INC.
Organization subpart: No
Enumeration date: May 19, 2025
Certification date: May 19, 2025
Last updated: May 19, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
156FX1800X	Technician/Technologist, Optician	–	–	Yes
332H00000X	Eyewear Supplier (Equipment, not the service)	–	–

Other names

Sam'S Optical Center 30-4956 (Doing Business As)

Practice location

2080 E Rio Salado Pkwy
Tempe, AZ 85288-4840

Phone 480-606-1806 · Fax 480-606-1811

Mailing address

702 Sw 8th St
Bentonville, AR 72716-0445

Authorized official

Kimberly Canonic
Senior Director
4802776348

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