Organization
SAM'S EAST, INC
Active
Parent organization
WAL-MART STORES INC
Other names
Sam's Pharmacy 30-4914
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
AMY POWERS (SPECIALIST, PLAN ENROLLMENT)
(479) 204-0709
Entity
Organization
Contact information
Practice address
2530 MARSHALL RD, SAN ANTONIO, TX 78259
(479) 204-0709
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
12/17/2013
Last updated
12/17/2013
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