Organization
SAMS EAST INC
Active
Other names
Sam's Club Pharmacy 10-8288
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEVINE (DIR HEALTHCARE CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
1500 TRADEWINDS BLVD, MIDLAND, TX 79706-2833
(432) 253-7669
(432) 253-7896
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
29259
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972919520
—
TX
01
—
2146779
PK
—
05
—
470015
—
TX
Enumeration date
07/03/2014
Last updated
08/29/2023
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