Organization
SAMS EAST INC
Active
Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-6675
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
7200 PEACH ST, ERIE, PA 16509-4754
(814) 866-0984
(814) 866-0986
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481756
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007752900024
—
PA
01
—
2082028
PK
—
Enumeration date
07/13/2007
Last updated
06/17/2025
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