SAM'S WEST, INC. SOS Verified
7100 ARROYO CROSSING PKWY, LAS VEGAS, NV 89113
NPI Number
1003092438
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: SAM'S WEST, INC.
Entity Number: C20638-1996
Entity Type: Foreign Corporation
Entity Status: Withdrawn
Formation Date: 1996-10-01
Status Changed: 2000-04-11
Name Match: 95%
Medicaid Payments After Loss of Active Status
This provider's Nevada Secretary of State registration was withdrawn on 2000-04-11, but continued receiving Medicaid payments through 2021-12 — 260 months after losing active status.
Nevada law requires healthcare providers to maintain active business registration. Payments to entities without active registration may warrant investigation by the Nevada Attorney General's office.
Registered Agent
Name: CORPORATION SERVICE COMPANY*
Type: Commercial Registered Agent
Address: 112 NORTH CURRY STREET, Carson City, NV, 89703
Research Report
Operates as: Walmart Inc.
Sam's West, Inc. is the operating entity for Sam's Club (Walmart subsidiary, NYSE: WMT). National retail/pharmacy chain. NV SOS entity withdrew but Sam's Club continues to operate multiple locations in Nevada.
Source: www.samsclub.com
Confirmed DBA
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| President | DAVID GLASS | 702 SW 8TH ST, BENTONVILLE, AR, 72716 | Active |
| Secretary | ROBERT RHOADS | 702 SW 8TH ST, BENTONVILLE, AR, 72716 | Active |
| Treasurer | JOSEPH FITZSIMMONS | 702 SW 8TH ST, BENTONVILLE, AR, 72716 | Active |
| Treasurer | JOSEPH FITZSIMMONS | 702 SW 8TH ST, BENTONVILLE, AR, 72716 | Inactive |
| President | DAVID GLASS | 702 SW 8TH ST, BENTONVILLE, AR, 72716 | Inactive |
| Secretary | ROBERT RHOADS | 702 SW 8TH ST, BENTONVILLE, AR, 72716 | Inactive |
Payments by Year
How much Medicaid paid this provider each year. Large jumps can indicate changes in practice volume or billing patterns.
| Year | Total Paid | % of Max |
|---|---|---|
| 2021 | $0 |
Procedure Code Breakdown
The specific medical services this provider billed Medicaid for. Each HCPCS/CPT code represents a different type of visit, test, or treatment.
| HCPCS Code | Description | Claims | Paid | % of Total | Avg per Claim |
|---|---|---|---|---|---|
| 0064A | Medical service or procedure | 46 | $0 | 0.0% | $0 |
| 0011A | Medical service or procedure | 60 | $0 | 0.0% | $0 |
| 0012A | Medical service or procedure | 43 | $0 | 0.0% | $0 |