Organization
SAMS WEST INC
Active
Other names
Sams Pharmacy 10-4873
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
8480 ANDERMATT DR, LINCOLN, NE 68526-9755
(402) 975-6908
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2941
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026421801
—
NE
01
—
2135598
PK
—
Enumeration date
06/05/2012
Last updated
06/05/2025
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