| NPI | 1902223019 |
|---|---|
| Doing Business As | SAM'S CLUB PHARMACY 10-6247 |
| Entity Type | Organization |
| Authorized Contact | LAURA LEVINE Dir Gov Contracting 479-204-8550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2014016142) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2016-06-13 |