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Organization

SAMS EAST INC

Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-6342
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
6922 S MINGO RD, TULSA, OK 74133-3216
(918) 294-9100
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
24279
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100245300A
OK
05
100246790C
OK
01
2076178
PK
Enumeration date
07/16/2006
Last updated
06/16/2025
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