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NPI Code Detail

MEDICARE: SAMS WEST INC

MEDICARE: SAMS WEST INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail Pharmacy054014452IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12020761OTHERPK

General Provider Information

NPI Number : 1760409056
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAMS WEST INC
Provider Business Mailing Address
First Line : 702 SW 8TH ST
Second Line :
City : BENTONVILLE
State : AR
Zip : 72716-0445
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9500 JOLIET RD
Second Line :
City : HODGKINS
State : IL
Zip : 60525-4137
Country : US
Telephone Number : 708-485-7563
Fax Number :
Authorized Official
Title or Position : MGR OF GOVERNMENT CONTRACTING
Name : LAURA LEVINE
Credential :
Telephone Number : 479-204-8550
Provider Enumeration Date : 07/16/2006
Last Update Date : 08/23/2023

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Directions to “SAMS WEST INC ” Practice Location

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