Organization
SAMS WEST INC
Active
Other names
SAMS PHARMACY 10-8208
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
12200 W 95TH ST, LENEXA, KS 66215-3806
(913) 894-2093
(913) 894-2261
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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-09522
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100444790A
—
KS
05
—
1477570893
—
MO
01
—
2026890
PK
—
05
—
6087176401
—
KS
Enumeration date
07/16/2006
Last updated
06/19/2025
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