Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
Sam's Pharmacy 10-4991
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
450 TOWNSEND RD, COCOA, FL 32926-3308
(321) 639-6211
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24143
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001254200
—
FL
01
—
2120175
PK
—
Enumeration date
05/07/2009
Last updated
08/30/2023
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