Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
Sams Pharmacy 10-4874
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
69630 STIRLING BLVD, COVINGTON, LA 70433-4620
(985) 327-6261
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY-006607-RC
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2136826
PK
—
05
—
2201760
—
LA
Enumeration date
08/23/2012
Last updated
08/29/2023
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