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Organization
SAMS EAST INC
Active
Organization
SAMS EAST INC
Active
Other names
SAM'S PHARMACY 10-8167
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
6705 S 27TH ST, FRANKLIN, WI 53132-9430
(414) 304-1255
(414) 304-1296
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
8423-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110149
PK
—
05
—
33277400
—
WI
Enumeration date
07/16/2006
Last updated
06/18/2025
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