Organization
SAMS WEST INC
Active
Other names
SAMS PHARMACY 10-6427
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
3410 55TH ST NW, ROCHESTER, MN 55901-0123
(507) 292-5783
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
262643
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2048592
PK
—
05
—
800546000
—
MN
Enumeration date
07/19/2006
Last updated
06/16/2025
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