Sam's East, INC

NPI #1255767091 in Mansfield, Texas

Provider Information

NPI Number: 1255767091
Entity Type: Organization
Organization Name: Sam's East, INC
Subpart: Yes (part of a larger organization)
Parent Organization: WAL-MART STORES, INC.
Primary Specialty: Eyewear Supplier
Enumeration Date: Sep 25, 2013
Last Updated: Sep 25, 2013

Practice Location

Address: 1740 NORTH FM 157
City: Mansfield
State: Texas
ZIP Code: 76063
Phone: (817) 779-6064

Authorized Official

Name: AMY POWERS
Title: SPECIALIST, PLAN ENROLLMENT
Phone: (479) 204-0709

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician/Technologist - Optician — Optician	156FX1800X
Eyewear Supplier	332H00000X	Primary

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