Sams East Inc
Sams East Inc is a healthcare organization registered as Community/Retail Pharmacy in Independence, MO, holding Type 2 (organization) NPI 1780601013 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum Organization subpart
| NPI | 1780601013 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Sams East Inc |
| Other name | <Unavail> |
| Parent organization | Wal-Mart Stores Inc |
| Practice address | 4100 S BOLGER RD, Independence, MO, 64055 |
| Phone | 8163502931 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2025-06-18 |
Authorized official
| Name | Kimberly Canonic |
|---|---|
| Title | Senior Director, Enrollment |
| Phone | 4808530515 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 333600000X | Pharmacy | Secondary | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 2001007427 | MO |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2048693 | Other | — | PK |
| 605268309 | Medicaid | MO | — |
Copy-ready billing details
Provider: Sams East Inc NPI: 1780601013 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 4100 S BOLGER RD, Independence, MO, 64055
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1316023518 | Sam'S Club Optical | Organization | Eyewear Supplier | Independence, MO |
| 1457875411 | Heather Janes | Individual | Pharmacist | Independence, MO |
| 1306332622 | Mohmmad Khoshneviszadeh | Individual | Ambulatory Care Pharmacist | Independence, MO |
Verify this record
Cross-check NPI 1780601013 against the authoritative CMS record: view Sams East Inc on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Sams East Inc?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-18.