Organization
SAMS EAST INC
Active
Other names
Sams Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
9900 S INTERSTATE 35, AUSTIN, TX 78748-3885
(512) 582-4883
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
27579
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831482389
—
TX
01
—
2130364
PK
—
05
—
470263
—
TX
Enumeration date
05/17/2011
Last updated
06/19/2025
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