Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
Sams Pharmacy 10-6435
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
1401 SKYLAND BLVD E, TUSCALOOSA, AL 35405-4229
(205) 345-2016
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
113876
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147783
—
AL
01
—
2133390
PK
—
Enumeration date
01/03/2012
Last updated
06/16/2025
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