Organization
SAMS EAST INC
Active
Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
Sams Pharmacy 10-6458
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
3912 WARDS RD, LYNCHBURG, VA 24502-2942
(434) 237-7027
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
0201004486
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336497395
—
VA
01
—
2136611
PK
—
Enumeration date
08/23/2012
Last updated
06/17/2025
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