Organization
SAMS WEST INC
Active
Other names
Sam's Pharmacy 10-4987
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIR. HEALTHCARE CONTRACT & ENROLLME)
(479) 277-2500
Entity
Organization
Contact information
Practice address
1200 S HOVER ST, LONGMONT, CO 80501-7902
(303) 845-4219
(303) 682-6418
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PDO.1680000116
CO
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366801557
—
CO
01
—
2159365
PK
—
Enumeration date
02/16/2016
Last updated
08/29/2023
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