NPIMap

Organization Active NPI

Sams East Inc

  • Community/Retail Pharmacy
  • Columbus, GA
National Provider Identifier
1194880153
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE009111 Issued in GA
Legal business name
SAMS EAST INC
Practice address
5448 A Whittlesey Blvd
Columbus, GA 31909-7298
Phone
(706) 649-6322
Fax
(706) 649-6322
NPI assigned
Dec 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHRE009111 GA Primary

Addresses

Primary practice location

5448 A Whittlesey Blvd
Columbus, GA 31909-7298

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445

Other identifiers 2

IdentifierTypeStateIssuer
2016461OtherPK
401380410AMedicaidGA

Other names 1

  • SAMS PHARMACY 10-8213 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930056580 GA DME Supplier - PharmacyDME Supplier - Optician 7012038581 Practice locations: Columbus, GA
O20130625000733 GA Part B Supplier - Mass Immunization (Roster Biller Only) 7012038581 23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albany, GA; Woodstock, GA; Valdosta, GA; Tucker, GA; Snellville, GA; Sharpsburg, GA; Savannah, GA; Pooler, GA…

Other NPIs on the same Medicare enrollment 22

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Sam'S Hearing Aid Center 6332819 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1194880153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5448 A WHITTLESEY BLVD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319097298",
            "telephone_number": "706-649-6322",
            "fax_number": "706-649-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMS EAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "CANONIC",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, ENROLLMENT",
        "authorized_official_telephone_number": "480-853-0515"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2016461",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401380410A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAMS PHARMACY 10-8213",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SAMS PHARMACY 10-8213",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.