Organization
SAM'S WEST, INC.
Active
Organization
SAM'S WEST, INC.
Active
Parent organization
WAL-MART STORES, INC.
Other names
Sam's Club Pharmacy 10-4749
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC.
Authorized official
LAURA LEVINE (DIR. HEALTHCARE CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
1250 SOURTH AMITY RD, CONWAY, AR 72032
(501) 205-7460
(501) 205-7459
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218595407
—
AR
Enumeration date
10/20/2016
Last updated
08/29/2023
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