Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-6354
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
901 WALMART WAY, MIDLOTHIAN, VA 23113-2600
(804) 897-0974
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
0201003720
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008502595
—
VA
01
—
2105055
PK
—
05
—
8502595
—
VA
Enumeration date
07/16/2006
Last updated
07/16/2013
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