Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-6355
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
2435 US HIGHWAY 70 SE, HICKORY, NC 28602-8301
(828) 326-7009
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
07859
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0186199
—
NC
05
—
186199
—
NC
01
—
2068914
PK
—
Enumeration date
07/18/2006
Last updated
06/16/2025
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