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Organization
SAMS WEST INC
Active
Organization
SAMS WEST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
2151 SHEPARD RD, NORMAL, IL 61761-6414
(309) 454-5478
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
054015057
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021471
PK
—
Enumeration date
07/16/2006
Last updated
07/25/2014
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