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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
4949 GREENWOOD DR, CORPUS CHRISTI, TX 78416-1344
(361) 855-7995
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
21299
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2096529
PK
05
470865
TX
Enumeration date
07/16/2006
Last updated
06/19/2025
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