Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES, INC.
Other names
Sams Pharmacy 10-6465
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC.
Authorized official
DIANNA PAINTER (PHY ENROLLMENT SPECIALIST)
(479) 277-1238
Entity
Organization
Contact information
Practice address
2827 DUNVALE RD, HOUSTON, TX 77063-4403
(713) 787-0571
Mailing address
702 SW 8TH ST., BENTONVILLE, AR 72716-6209
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
19252
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4503454
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
464255
—
TX
Enumeration date
07/16/2006
Last updated
12/29/2009
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