Organization · Type 2 NPI

Sams East Inc

Community/Retail Pharmacy · St. Louis, MO

NPI number 1316964653 Active

Practice location

4512 Lemay Ferry Rd
St. Louis, MO 63129-1614

Call (314) 894-6893 Map

Fax (314) 894-5915

Mailing address

702 SW 8th St
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	2006006593 (MO)

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

5 other providers at this address

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NPI record

NPI: 1316964653
Entity type: Organization (Type 2)
Issued: Jul 16, 2006
Last updated: Jun 19, 2025
Status: Active
Subpart: Yes of Wal-Mart Stores Inc

Other names

<unavail>
Sams Pharmacy 10-8205 · doing business as

Authorized official

Kimberly Canonic
Senior Director, Enrollment
(480) 853-0515

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1316964653

Sams East Inc's National Provider Identifier is 1316964653, issued on Jul 16, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in St. Louis, MO. The record was last updated on Jun 19, 2025.