Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-8265
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
2025 SAMS WAY, LAKE CHARLES, LA 70601-8783
(337) 477-2775
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5587RC
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1233633
—
LA
01
—
2035300
PK
—
05
—
5587
—
LA
Enumeration date
07/17/2006
Last updated
06/19/2025
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