Organization
SAMS EAST INC
Active
Other names
SAMS PHARMACY 10-8271
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
257 GRANDVIEW BLVD, MADISON, MS 39110-5514
(601) 977-0948
Mailing address
1 CUSTOMER DR, MS 0445, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
05303/01.2
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00330706
—
MS
01
—
2046339
PK
—
05
—
330706
—
MS
Enumeration date
07/16/2006
Last updated
05/19/2026
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