Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-8144
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
1025 BLACK HORSE PIKE, PLEASANTVILLE, NJ 08232-4103
(609) 485-2047
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00666900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0142921
—
NJ
01
—
2056057
PK
—
Enumeration date
01/23/2007
Last updated
06/17/2025
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