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Organization
SAMS EAST INC
Active
Organization
SAMS EAST INC
Active
Other names
Sam's Pharmacy 10-6571
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
200 N BELTLINE DR, FLORENCE, SC 29501-7403
(843) 758-6087
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-2500
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
15076
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143424
PK
—
05
—
715076
—
SC
05
—
DE3567
—
SC
Enumeration date
12/13/2013
Last updated
06/17/2025
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