Organization
SAM'S WEST INC
Active
Parent organization
WAL-MART STORES INC
Other names
Sam's Pharmacy 10-4955
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
16573 W BELL RD, SURPRISE, AZ 85374-9892
(623) 584-0728
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
Y005062
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2118206
PK
—
Enumeration date
12/03/2008
Last updated
08/30/2023
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