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Organization

SAMS EAST INC

Active
Other names
SAMS PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
MATT MCMULLIN (DIRECTOR OF GOVERNMENT CONTRACTING)
(479) 371-8711
Entity
Organization

Contact information

Practice address
1701 W STATE HIGHWAY 114, GRAPEVINE, TX 76051-8652
(682) 271-5221
(682) 271-5223
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
22788
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2099287
PK
05
469661
TX
Enumeration date
07/16/2006
Last updated
09/12/2024
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