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Organization
SAMS EAST INC
Active
Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
Sam's Pharmacy 106681
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
LAURA LEVINE (MGR GOVERNMENT CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
25 PACE BLVD, WARWICK, RI 02886-4244
(401) 262-3145
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
3336C0003X
Community/Retail Pharmacy
Primary
PHA00560
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140660
PK
—
05
—
SA95679
—
RI
Enumeration date
06/04/2013
Last updated
04/02/2014
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