Organization
SAMS WEST INC
Active
Other names
SAMS PHARMACY 10-8272
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
4385 VENETUCCI BLVD, COLORADO SPRINGS, CO 80906-4049
(719) 637-3874
(719) 637-3961
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
240000103
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03003803
—
CO
01
—
2003236
PK
—
05
—
3003803
—
CO
Enumeration date
07/16/2006
Last updated
06/17/2025
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