Organization
SAMS EAST INC
Active
Other names
SAMS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
1213 MARKET PL, IRVING, TX 75063-7235
(972) 401-0230
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
20733
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2095102
PK
—
05
—
469703
—
TX
Enumeration date
07/18/2006
Last updated
06/17/2025
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