MEDICARE: SAMS EAST INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PH18784	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2014977	OTHER	PK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578580973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMS EAST INC

Provider Business Mailing Address
First Line	:	702 SW 8TH ST
Second Line	:
City	:	BENTONVILLE
State	:	AR
Zip	:	72716-0445
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5300 30TH ST E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34203-8400
Country	:	US
Telephone Number	:	941-727-6896
Fax Number	:

Authorized Official
Title or Position	:	SENIOR DIRECTOR, ENROLLMENT
Name	:	KIMBERLY CANONIC
Credential	:
Telephone Number	:	480-853-0515

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	06/18/2025

Similar Medicare Providers

1891629333 — KARA LACHENMEIER
Practice Location Address:

5300 30TH ST E
BRADENTON, FL
34203-8400

Practice Phone: 941-752-0281
Practice Fax:

1437240710 — SAM'S CLUB OPTICAL
Practice Location Address:

5300 30TH ST E
BRADENTON, FL
34203-8400

Practice Phone: 941-739-2130
Practice Fax:

1083214001 — DUC NAM PHAM
Practice Location Address:

5300 30TH ST E
BRADENTON, FL
34203-8400

Practice Phone: 941-727-6896
Practice Fax:

1831799600 — VU TRAN
Practice Location Address:

5300 30TH ST E
BRADENTON, FL
34203-8400

Practice Phone: 941-727-6896
Practice Fax:

1649321852 — DR. THOMAS J BEVELOCK D.M.D.
Practice Location Address:

10940 E STATE ROAD 70 , SUITE 102
BRADENTON, FL
34202-8400

Practice Phone: 941-756-9604
Practice Fax: 941-756-0616

1861642951 — MRS. JENNIFER LAMORA LCSW
Practice Location Address:

10920 E STATE ROAD 70
BRADENTON, FL
34202-8400

Practice Phone: 941-753-0175
Practice Fax:

Directions to “SAMS EAST INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.