# SAMS EAST INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WAL-MART STORES INC
- **Other names:** Sams Pharmacy 10-4790
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1285868653
- **Legal business name:** WAL-MART STORES INC
- **Authorized official:** LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
- **Authorized official phone:** (479) 204-8550

## Contact information

- **Practice address:** 90 BASS PRO DR, PEARL, MS 39208-9242
- **Practice address phone:** (601) 939-6442
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0445
- **Mailing address phone:** (479) 277-1238
- **Mailing address fax:** (479) 277-4331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 08122/01.2 | MS | Yes |

## Other

- **Enumeration date:** 05/13/2009
- **Last updated:** 08/29/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00174351 | — | MS |
| 01 | — | 2120765 | PK | — |