Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-4820
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
15 MILL CREEK CIR, POOLER, GA 31322-2151
(912) 748-3136
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
PHRE009083
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016328
PK
—
05
—
250703357B
—
GA
Enumeration date
10/03/2006
Last updated
08/29/2023
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