Organization
SAMS EAST INC
Active
Other names
SAMS PHARMACY 10-6437
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
3205 W STATE ROAD 45, BLOOMINGTON, IN 47403-5107
(812) 333-8903
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
60005630B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200369720
—
IN
05
—
200369720A
—
IN
01
—
2024506
PK
—
Enumeration date
07/17/2006
Last updated
08/23/2023
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