Organization
SAMS EAST INC
Active
Other names
Sam's Pharmacy 10-4871
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEVINE (MANAGER, GOV'T CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
715 BONITA DR, MERIDIAN, MS 39301-4603
(601) 286-6035
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-0709
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
12013/1.2
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139018
PK
—
Enumeration date
02/19/2013
Last updated
08/24/2023
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