Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-6670
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
2000 CLEMENTS BRIDGE RD, STE 116, WOODBURY, NJ 08096-2016
(856) 853-7137
Mailing address
MAIL STOP 0445, 702 SW 8TH ST, BENTONVILLE, AR 72716
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00682800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0191035
—
NJ
01
—
2116766
PK
—
Enumeration date
08/07/2008
Last updated
06/17/2025
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