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Organization

SAMS EAST INC

Active
Other names
SAMS PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization

Contact information

Practice address
1405 EARL RUDDER FWY S, COLLEGE STATION, TX 77845-6033
(979) 696-0128
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
25584
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2100253
PK
05
469691
TX
Enumeration date
06/26/2007
Last updated
06/16/2025
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