Organization
SAMS EAST INC
Active
Organization
SAMS EAST INC
Active
Other names
Sam's Club Pharmacy 10-4857
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEVINE (DR. HEALTHCARE & ENROLLMENT)
(479) 204-8550
Entity
Organization
Contact information
Practice address
301 SW PINE ISLAND ROAD, CAPE CORAL, FL 33991
(239) 800-6027
(239) 800-6030
Mailing address
702 SW 8TH ST, MAILSTOP: 0445, BENTONVILLE, AR 72716-0445
(479) 277-2500
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH28751
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014113800
—
FL
05
—
014113801 DME
—
FL
01
—
2148795
PK
—
Enumeration date
10/21/2014
Last updated
08/30/2023
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