Organization
SAMS WEST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-4786
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
145 W CACHE VALLEY BLVD, LOGAN, UT 84341-8473
(435) 787-0495
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
51674061703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2101076
PK
—
Enumeration date
07/16/2006
Last updated
08/29/2023
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