Organization · Type 2 NPI

Sams West Inc

Community/Retail Pharmacy · Glen Carbon, IL

NPI number 1003158676 Active

Practice location

5 Illini Dr
Glen Carbon, IL 62034-3929

Call (618) 692-7568 Map

Fax (618) 692-7633

Mailing address

702 SW 8th St
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	054018277 (IL)

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

6 other providers at this address

Other community/retail pharmacy providers in Glen Carbon

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NPI record

NPI: 1003158676
Entity type: Organization (Type 2)
Issued: Mar 21, 2013
Last updated: Jun 6, 2025
Status: Active
Subpart: Yes of Wal-Mart Stores Inc

Other names

<unavail>
Sam's Pharmacy 10-4878 · doing business as

Authorized official

Kimberly Canonic
Senior Director, Enrollment
(480) 277-6348

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1003158676

Sams West Inc's National Provider Identifier is 1003158676, issued on Mar 21, 2013. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Glen Carbon, IL. The record was last updated on Jun 6, 2025.