Organization
SAMS EAST INC
Active
Other names
Sam's Club Pharmacy 10-6189
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEVINE (DIR HEALTHCARE CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
1500 S ORANGE BLOSSOM TRL, APOPKA, FL 32703
(407) 553-4108
(407) 553-4107
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-6209
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH29210
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014113800
—
FL
05
—
014113801 DME
—
FL
05
—
015339100
—
FL
05
—
015339101 DME
—
FL
01
—
2152268
PK
—
Enumeration date
05/29/2015
Last updated
08/29/2023
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