Organization
SAMS WEST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-4718
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
11278 S JORDAN GTWY, SOUTH JORDAN, UT 84095-4111
(801) 545-9801
Mailing address
702 SW 8TH ST, MAIL STOP 0445, 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
70004991703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2100987
PK
—
Enumeration date
07/07/2008
Last updated
08/29/2023
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