Organization
SAMS EAST INC
Active
Other names
SAMS PHARMACY 10-4851
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEVINE (DIR H&W)
(479) 204-8550
Entity
Organization
Contact information
Practice address
1301 VETERANS PKWY, CLARKSVILLE, IN 47129-7747
(812) 218-0447
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
60005850A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200489850
—
IN
05
—
200489850A
—
IN
01
—
2025212
PK
—
Enumeration date
07/16/2006
Last updated
08/29/2023
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