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SAM'S CLUB PHARMACY 10-4749
NPI 1922559343
Pharmacy - Community/Retail Pharmacy in Conway, AR

Active since October 20, 2016CLIA 04D2122878 · Waiver
1250 SOURTH AMITY RD, CONWAY, AR 72032(501) 205-7460(501) 205-7459 Get Directions Write a Review

NPPES record last updated: August 29, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 29, 2023, Apr 17, 2017, Oct 20, 2016 (3 updates tracked since 2016).

About Sam's Club Pharmacy 10-4749 NPPES

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

SAM'S CLUB PHARMACY 10-4749 (NPI 1922559343) is a healthcare organization registered as a community/retail pharmacy in Conway, Arkansas and active in the NPI registry since October 2016. The organization holds a CLIA Waiver certificate valid through December 7, 2026 and lists Laura Levine, Dir. Healthcare Contracting, as its authorized official.

NPPES Registry Identity

NPI1922559343
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSAM'S WEST, INC.
Location Address1250 SOURTH AMITY RDConway, AR 72032
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 277-1242 · Fax (479) 277-4331
Phone(501) 205-7460
Fax(501) 205-7459
Organization SubpartYesParent: Wal-mart Stores, Inc.
Authorized OfficialLaura LevineDir. Healthcare Contracting · (479) 204-8550
Enumeration DateOctober 20, 2016
Last NPPES UpdateAugust 29, 20233 updates tracked since enumeration
NPPES CertifiedAugust 29, 2023
✔ NPI 1922559343 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
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
1250 SOURTH AMITY RD, Conway, AR 72032
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Other Names 1

Doing Business AsSam's Club Pharmacy 10-4749

Other Identifiers 1

Medicaid218595407AR

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 ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D2122878

Sam's Club Pharmacy 10-4749 · Conway, AR
Active · expires Dec 7, 2026
CLIA Number04D2122878
Laboratory TypePharmacy
Certificate Effective DateDecember 8, 2024
Certificate Expiration DateDecember 7, 2026
Laboratory DirectorMatthew Morgan
Laboratory Phone(479) 258-2243
Laboratory LocationSam's Club Pharmacy 10-47491250 South Amity Rd, Conway, AR 72032
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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.
156 services153 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.
143 services143 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.
18 services18 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.
11 services11 patients

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Sam's Club Pharmacy 10-4749 carries, from the Medicare DMEPOS supplier directory.

Sam's Club Pharmacy 10-4749

DMEPOS supplier · Conway, AROperated by Sams West Inc
✔

Accepts Medicare assignment

Sam's Club Pharmacy 10-4749 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)20452421
Medicare Participant SinceNovember 1, 2018
Supplier Location1250 S Amity RdConway, AR 72032
Phone(501) 205-7460
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.

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 Sam's West, Inc.'s NPI number?

The NPI number for Sam's West, Inc. is 1922559343. It was assigned to this organization in the NPPES registry on October 20, 2016. The provider is doing business as Sam's Club Pharmacy 10-4749.

Where is Sam's West, Inc. located?

Sam's West, Inc. is located at 1250 Sourth Amity Rd, Conway, AR 72032. The listed phone number is (501) 205-7460.

What is Sam's West, Inc.'s specialty?

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

Does Sam's West, Inc. accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Sam's Club Pharmacy 10-4749 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Sam's West, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2122878) is associated with this NPI, valid through December 7, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sam's 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 52 other insurers list Sam's 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 Sam's West, Inc. was last updated on August 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.