Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAM'S PHARMACY 10-8278
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
1211 WOODRUFF RD, GREENVILLE, SC 29607-5737
(864) 987-1090
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
6911
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2092265
PK
—
05
—
769111
—
SC
05
—
DE2612
—
SC
Enumeration date
07/16/2006
Last updated
06/17/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us