Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sam's West, Inc

Organization Optician · NPI 1275945255

Sam's West, Inc is an Optician in Montgomery, Illinois. Registered with an NPI since 2014.

In the registry since
2014
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1050 Ogden Ave
Montgomery, IL 60538-5404
Phone: (630) 449-1953
Fax: (630) 449-1954
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Eyewear Supplier (primary) Taxonomy 332H00000X
Optician Taxonomy 156FX1800X

Record details

NPI number1275945255
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationWal-Mart Stores, Inc
Authorized official Kimberly Canonic — Sr. Director · (479) 371-1168
Other names Sam'S Club Vision Center 30-6388
NPI enumeratedMay 27, 2014
Last updated in NPPESSeptember 29, 2025
Certification dateSeptember 29, 2025
Mailing address1 Customer Dr, Ms 0445, Bentonville, AR 72716-0445

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