SAMS WEST INC
NPI 1104843440
Pharmacy - Community/Retail Pharmacy in Glendora, CA

Q: What is Sams West Inc's NPI number?

The NPI number for Sams West Inc is 1104843440. It was assigned to this organization in the NPPES registry on July 16, 2006. The provider is doing business as Sams Pharmacy 10-6240.

Q: What is Sams West Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Q: When was this NPI record last updated?

The NPPES record for Sams West Inc was last updated on June 16, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 16, 2006

1301 S LONE HILL AVE, GLENDORA, CA 91740(909) 394-7978 Get Directions Write a Review

NPPES record last updated: June 16, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Sams West Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMS WEST INC (NPI 1104843440), doing business as Sams Pharmacy 10-6240, is a healthcare organization registered as a community/retail pharmacy in Glendora, California and active in the NPI registry since July 2006. The organization lists Kimberly Canonic, Senior Director, as its authorized official.

NPPES Registry Identity

NPI1104843440

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameSAMS WEST INC

Location Address1301 S LONE HILL AVEGlendora, CA 91740-5348

Mailing Address702 Sw 8th StBentonville, AR 72716-0445

Phone(909) 394-7978

Organization SubpartYesParent: Wal-mart Stores Inc

Authorized OfficialKimberly CanonicSenior Director · (480) 853-0515

Enumeration DateJuly 16, 2006

Last NPPES UpdateJune 16, 2025

NPPES CertifiedJune 16, 2025

✔ NPI 1104843440 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in CA · PHY45344

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

Also ListedPharmacyTaxonomy 333600000X

1301 S LONE HILL AVE, Glendora, CA 91740

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Other Names 1

Doing Business AsSams Pharmacy 10-6240

Other Identifiers 2

Other1997975Pk

Medicaid463PHA453440CA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

123 services123 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

116 services116 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

14 services14 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

14 services14 patients

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Sam's Pharmacy 10-6240 carries, from the Medicare DMEPOS supplier directory.

Sam's Pharmacy 10-6240

DMEPOS supplier · Glendora, CAOperated by Sams West Inc

✔

Accepts Medicare assignment

Sam's Pharmacy 10-6240 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20452187

Medicare Participant SinceNovember 1, 2018

Supplier Location1301 S Lone Hill AveGlendora, CA 91740

Phone(909) 394-7978

Supplier Specialties

Pharmacy Optician

Medicare Product Categories

Epoetin

Epoetin is a man-made version of human erythropoietin (EPO)

Immunosuppressive Drugs

Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant

Infusion Drugs

Nebulizer Drugs

Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect

Oral Anticancer Drugs

FDA anticancer drugs

Oral Antiemetic Drugs

FDA antiemetic drugs

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FIRSTSIGHT VISION SERVICES, INC.

Optometrist