Organization
SAMS EAST INC
Active
Other names
SAMS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
4400 BRYANT IRVIN RD, FORT WORTH, TX 76132-1064
(817) 989-1931
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
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
21479
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2096754
PK
—
05
—
469668
—
TX
Enumeration date
07/16/2006
Last updated
08/29/2023
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