Organization
SAMS EAST INC
Active
Parent organization
WAL-MART STORES INC
Other names
SAMS PHARMACY 10-6521
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
2174 MARTIN LUTHER KING JR BLVD, HOUMA, LA 70360-2275
(985) 851-2142
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5630RC
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1233889
—
LA
01
—
2035351
PK
—
05
—
5630 RC
—
LA
Enumeration date
07/17/2006
Last updated
06/16/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us