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SAMS WEST INC
NPI 1295152635
Pharmacy - Community/Retail Pharmacy in Montgomery, IL

Active since March 24, 2014
1050 OGDEN AVE, MONTGOMERY, IL 60538(630) 449-1953 Get Directions Write a Review

NPPES record last updated: June 9, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Sams West Inc NPPES

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

SAMS WEST INC (NPI 1295152635), doing business as Sam's Club Pharmacy 10-6388, is a healthcare organization registered as a community/retail pharmacy in Montgomery, Illinois and active in the NPI registry since March 2014. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1295152635
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSAMS WEST INC
Location Address1050 OGDEN AVEMontgomery, IL 60538-5404
Mailing Address702 Sw 8th StBentonville, AR 72716-6209 · (479) 277-4000
Phone(630) 449-1953
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 277-6348
Enumeration DateMarch 24, 2014
Last NPPES UpdateJune 9, 2025
NPPES CertifiedJune 9, 2025
✔ NPI 1295152635 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 IL · 054.018634
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
1050 OGDEN AVE, Montgomery, IL 60538
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Other Names 1

Doing Business AsSam's Club Pharmacy 10-6388

Other Identifiers 1

Other2145248Pk

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.
75 services75 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.
73 services73 patients
Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5ml dosage, for intramuscular use 91304
The COVID-19 vaccine you'll receive is designed to protect against the virus. It contains tiny, harmless pieces of the virus's spike protein. These trigger your immune system to build a defense. The vaccine also includes a saponin-based adjuvant to enhance this response. It's given as a 0.5ml injection into a muscle.
22 services22 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.
13 services13 patients

Medical Equipment Supplier Medicare DMEPOS 6

Medicare supplier enrollment and the product categories Sams's Club Pharmacy 10-6388 carries, from the Medicare DMEPOS supplier directory.

Sams's Club Pharmacy 10-6388

DMEPOS supplier · Montgomery, ILOperated by Sams West Inc
✔

Accepts Medicare assignment

Sams's Club Pharmacy 10-6388 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)20452391
Medicare Participant SinceNovember 1, 2018
Supplier Location1050 Ogden AveMontgomery, IL 60538
Phone(630) 449-1953
Supplier Specialties
Pharmacy

Medicare Product Categories

Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Blood Glucose Monitors/Supplies (Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Ostomy Supplies
Pouches, Paste, Powder, Barrier wipes
Prosthetic Lenses: Conventional Eyeglasses
Conventional Eyeglasses
Enteral Nutrients
Enteral formula
Surgical Dressings
Gauze, Elastic bandages, Adhesive tape
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 3

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

SAM'S WEST, INC
Eyewear Supplier
1050 OGDEN AVE
MONTGOMERY, IL 60538
Kane County (630) 449-1953
DONNA SLAS RPH
Pharmacist (Ambulatory Care)
1050 OGDEN AVE
MONTGOMERY, IL 60538
Kane County (630) 449-1953
KEVIN GOODWIN
Optometrist
1050 OGDEN AVE
MONTGOMERY, IL 60538
Kane County (630) 449-1955

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sams West Inc's NPI number?

The NPI number for Sams West Inc is 1295152635. It was assigned to this organization in the NPPES registry on March 24, 2014. The provider is doing business as Sam's Club Pharmacy 10-6388.

Where is Sams West Inc located?

Sams West Inc is located at 1050 Ogden Ave, Montgomery, IL 60538. The listed phone number is (630) 449-1953.

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.

Does Sams West Inc accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Sams's Club Pharmacy 10-6388 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Sams West Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 48 other insurers list Sams West Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sams West Inc was last updated on June 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.