Sams West Inc
NPI 1114944402 · Community/Retail Pharmacy · Peoria, IL
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Sams West Inc is a Community/Retail Pharmacy organization in Peoria, IL (NPI 1114944402).
Provider details
- NPI number
- 1114944402
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Parent organization
- Wal-Mart Stores Inc
- Organization subpart
- Yes
- Authorized official
- Kimberly Canonic, Senior Director, Enrollment(480) 853-0515
Specialties & taxonomies
Suppliers
- Pharmacy333600000X
Suppliers
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
19 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
352 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Administration of Influenza Virus VaccineG0008 | 190 | $19 |
| Admn Sarscov2 Vacc 1 Dose90480 | 162 | $12 |
Typical Medicare-allowed amounts for these services range $12–$19 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Sams Pharmacy
Registry dates
- Enumerated
- 2006-07-16
- Last updated
- 2025-06-18
- Certified
- 2025-06-18
Frequently asked questions
- What is Sams West Inc's NPI number?
- Sams West Inc's National Provider Identifier (NPI) is 1114944402, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Sams West Inc?
- Sams West Inc is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Sams West Inc located?
- Sams West Inc's practice location on file with NPPES is 4100 W Willow Knolls Dr, Peoria, IL 61615-4405.
- What is Sams West Inc's phone number?
- The practice phone number listed in the NPPES registry for Sams West Inc is (309) 692-1508.
- Does Sams West Inc accept Medicare?
- Sams West Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Sams West Inc?
- The authorized official listed on Sams West Inc's NPPES record is Kimberly Canonic, Senior Director, Enrollment. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Sams West Inc's NPI active?
- Yes — Sams West Inc's NPI (1114944402) is active in the NPPES registry as of the last update on 2025-06-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.