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Organization
SAMS EAST INC
Active
Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
Sams Pharmacy 10-8237
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
5400 FRONTAGE RD, MONROE, LA 71202-4040
(318) 345-0207
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHY.006471-RC
LA
Other
Enumeration date
07/20/2011
Last updated
06/17/2025
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