Organization
SAMS WEST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-6378
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
6363 VALLEY SPRINGS PKWY, RIVERSIDE, CA 92507-0905
(951) 653-7850
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
46129
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997395
PK
—
05
—
463PHA461290
—
CA
Enumeration date
07/16/2006
Last updated
06/16/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us