Sams West INC

NPI #1790090983 in Sartell, Minnesota

Provider Information

NPI Number: 1790090983
Entity Type: Organization
Organization Name: Sams West INC
Subpart: Yes (part of a larger organization)
Parent Organization: WAL-MART STORES INC
Primary Specialty: Eyewear Supplier
Enumeration Date: Aug 11, 2010
Last Updated: Aug 11, 2010

Practice Location

Address: 207 COUNTY RD 120
City: Sartell
State: Minnesota
ZIP Code: 56301
Phone: (320) 202-5985

Authorized Official

Name: DIANNA PAINTER
Title: ENROLLMENT SPECIALIST
Phone: (479) 277-1238

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician/Technologist - Optician — Optician	156FX1800X
Eyewear Supplier	332H00000X	Primary

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