Organization
SAM'S DRUG MART, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM ANTHONY CALABRETTA JR. R.PH. (OWNER)
(330) 821-1780
Entity
Organization
Contact information
Practice address
475 E STATE ST, ALLIANCE, OH 44601-4909
(330) 821-1780
(330) 821-8045
Mailing address
475 E STATE ST, ALLIANCE, OH 44601-4909
(330) 821-1780
(330) 821-8045
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
02-0428650
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0591088
—
OH
01
—
22000000216013
ANTHEM PROVIDER #
OH
01
—
3643839
NCPDP
OH
Enumeration date
04/13/2007
Last updated
08/24/2010
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