# SAMS EAST INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sam's Pharmacy 10-4871
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316287998
- **Authorized official:** LAURA LEVINE (MANAGER, GOV'T CONTRACTING)
- **Authorized official phone:** (479) 204-8550

## Contact information

- **Practice address:** 715 BONITA DR, MERIDIAN, MS 39301-4603
- **Practice address phone:** (601) 286-6035
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0445
- **Mailing address phone:** (479) 204-0709
- **Mailing address fax:** (479) 277-4331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 12013/1.2 | MS | Yes |

## Other

- **Enumeration date:** 02/19/2013
- **Last updated:** 08/24/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2139018 | PK | — |