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SAMS WEST INC
NPI 1740374891
Pharmacy - Community/Retail Pharmacy in Fountain Valley, CA

Active since October 03, 2006
17099 BROOKHURST ST, FOUNTAIN VALLEY, CA 92708(714) 965-0958 Get Directions Write a Review

NPPES record last updated: June 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sams West Inc NPPES

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

SAMS WEST INC (NPI 1740374891), doing business as Sams Pharmacy 10-6615, is a healthcare organization registered as a community/retail pharmacy in Fountain Valley, California and active in the NPI registry since October 2006. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1740374891
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSAMS WEST INC
Location Address17099 BROOKHURST STFountain Valley, CA 92708-3601
Mailing Address702 Sw 8th StBentonville, AR 72716-0445
Phone(714) 965-0958
Organization SubpartYesParent: Wal-mart Stores Inc
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515
Enumeration DateOctober 3, 2006
Last NPPES UpdateJune 17, 2025
NPPES CertifiedJune 17, 2025
✔ NPI 1740374891 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in CA · PHY48207
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
17099 BROOKHURST ST, Fountain Valley, CA 92708
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Other Names 1

Doing Business AsSams Pharmacy 10-6615

Other Identifiers 1

Other2115121Pk

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.
129 services126 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.
119 services119 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.
17 services17 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.
16 services16 patients

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Sam's Club Pharmacy 10-6615 carries, from the Medicare DMEPOS supplier directory.

Sam's Club Pharmacy 10-6615

DMEPOS supplier · Fountain Valley, CAOperated by Sams West Inc
✔

Accepts Medicare assignment

Sam's Club Pharmacy 10-6615 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)20452133
Medicare Participant SinceNovember 1, 2018
Supplier Location17099 Brookhurst StFountain Valley, CA 92708
Phone(714) 965-0958
Supplier Specialties
Pharmacy

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 4

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

FIRSSIGHT VISION SERVICES, INC.
Optometrist
17099 BROOKHURST ST
FOUNTAIN VALLEY, CA 92708
Orange County (714) 965-1070
DR. GEMIE N PHAM O.D.
Optometrist
17099 BROOKHURST ST
FOUNTAIN VALLEY, CA 92708
Orange County (714) 968-4269
KEVIN VU
Pharmacist
17099 BROOKHURST ST
FOUNTAIN VALLEY, CA 92708
Orange County (714) 965-0958
GEMIE N PHAM, OD PROFESSIONAL CORPORATION
Optometrist
17099 BROOKHURST ST
FOUNTAIN VALLEY, CA 92708
Orange County (714) 968-4269

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 1740374891. It was assigned to this organization in the NPPES registry on October 3, 2006. The provider is doing business as Sams Pharmacy 10-6615.

Where is Sams West Inc located?

Sams West Inc is located at 17099 Brookhurst St, Fountain Valley, CA 92708. The listed phone number is (714) 965-0958.

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, Sam's Club Pharmacy 10-6615 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 47 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 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.