Organization
SAM'S EAST INC
Active
Organization
SAM'S EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
Sam's Pharmacy 10-4992
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
1500 RING RD, ELIZABETHTOWN, KY 42701-7984
(270) 763-0755
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P07309
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2118204
PK
—
05
—
7100089090
—
KY
Enumeration date
12/03/2008
Last updated
08/30/2023
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