Organization
SAMS EAST INC
Active
Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-4784
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
2711 N TELSHOR BLVD, LAS CRUCES, NM 88011-8202
(575) 521-7890
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH00002463
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2058872
PK
—
05
—
23006714
—
NM
Enumeration date
07/16/2006
Last updated
08/29/2023
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