| NPI | 1912364365 |
|---|---|
| Doing Business As | SAM'S CLUB PHARMACY 10-7189 |
| Entity Type | Organization |
| Authorized Contact | LAURA LEVINE Dir Healthcare Conctract & Enrollme 479-204-8550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: OK 17521) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2016-07-21 |