Organization
SAMS WEST INC
Active
Other names
Sams Pharmacy 10-8183
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
207 COUNTY ROAD 120, SAINT CLOUD, MN 56303-4872
(320) 229-8795
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
263574
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043524135
—
MN
01
—
2126070
PK
—
Enumeration date
07/30/2010
Last updated
06/18/2025
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