Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
Sams Pharmacy 10-4790
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
90 BASS PRO DR, PEARL, MS 39208-9242
(601) 939-6442
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
08122/01.2
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00174351
—
MS
01
—
2120765
PK
—
Enumeration date
05/13/2009
Last updated
08/29/2023
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