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
700 N 54TH ST, QUINCY, IL 62305-7909
(217) 222-6682
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054016510
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1482431
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/22/2008
Last updated
08/23/2023
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