Sam'S Pharmacy 10-4787
LBN: Sams West Inc
Sam'S Pharmacy 10-4787 is an health care organization with primary practice located at 200 American Blvd W , Bloomington MN 55420-1120. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Sams West Inc can be contacted via phone (952) 888-6079, or through Gundberg, Cory Jon via phone (479) 277-2500.
Contact Information
Primary practice address
200 American Blvd W
Bloomington MN 55420-1120
Phone: (952) 888-6079
Fax: (952) 888-6095
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 262274 | Minnesota |
Profile Details
| NPI number | 1356368757 |
|---|---|
| LBN Legal business name | Sams West Inc |
| DBA Doing business as | Sam'S Pharmacy 10-4787 |
| Authorized official | Gundberg, Cory Jon |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 16th, 2006 |
| Last updated | Aug 29th, 2023 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356368757 | NPPES |
| Minnesota | MEDICAID | 470053800 | |
| Minnesota | Other | 2048384 |
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