Organization
SAMS WEST INC
Active
Parent organization
WAL-MART STORES INC
Other names
Sams Pharmacy
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
603 RIVER OAKS W, CALUMET CITY, IL 60409-5408
(708) 832-2684
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(708) 985-1759
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054016517
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1482265
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/21/2008
Last updated
08/23/2023
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