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Organization

SAMS EAST INC

Active
Parent organization
WAL-MART STORES INC
Other names
Sams Pharmacy 10-6569
Organization subpart
Yes

Provider details

NPI number
Legal business name
WAL-MART STORES INC
Authorized official
LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
(479) 204-8550
Entity
Organization

Contact information

Practice address
601 COMMERCE DR, BLUEFIELD, VA 24605-9221
(276) 322-3834
(276) 322-3814
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
0201004358
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003122870
VA
05
1871804286
VA
01
2126472
PK
05
3810021292
WV
Enumeration date
08/31/2010
Last updated
08/23/2023
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