Organization
SAMS EAST INC
Active
Other names
Sam's Club Pharmacy 10-4939
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEVINE (DIRECTOR GOVERNMENT CONTRACTIN)
(479) 204-8550
Entity
Organization
Contact information
Practice address
3239 GOLIAD RD, SAN ANTONIO, TX 78223-4608
(210) 507-0492
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28986
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649691478
—
TX
01
—
2143615
PK
—
05
—
469672
—
TX
Enumeration date
12/20/2013
Last updated
08/28/2023
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