Organization
SAMS WEST INC
Active
Parent organization
WAL-MART STORES INC
Other names
Sams Pharmacy 10-4791
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
3010 LARUE ST, GARDEN CITY, KS 67846-7072
(620) 272-9001
Mailing address
MAIL STOP 0445, 702 SW 8TH ST, BENTONVILLE, AR 72716
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-10215
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100444790H
—
KS
01
—
2117043
PK
—
Enumeration date
08/22/2008
Last updated
08/29/2023
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