Organization
SAMS WEST INC
Active
Other names
SAMS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
4900 N 27TH ST, LINCOLN, NE 68521-1194
(402) 438-3015
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2475
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2055590
PK
—
Enumeration date
07/16/2006
Last updated
06/17/2025
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