Organization
SAMS WEST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-4915
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
600 HIGHWAY 95 STE 200, BULLHEAD CITY, AZ 86429-5005
(928) 754-3961
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
Y004332
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1991948
PK
—
05
—
977308
—
AZ
05
—
Y04332
—
AZ
Enumeration date
01/03/2007
Last updated
08/30/2023
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