Active NPI
Sams East Inc
Doing business as Sam's Club Pharmacy 10-6269
- Community/Retail Pharmacy
- Harlingen, TX
National Provider Identifier
1851715999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 29001
- Legal business name
- SAMS EAST INC
- Doing business as
- Sam's Club Pharmacy 10-6269
- Practice address
- 621 N Expressway 77
Harlingen, TX 78552-5202 - Phone
- (956) 507-7305
- Fax
- (956) 507-7316
- NPI assigned
- Feb 10, 2014
- Last updated
- Jun 15, 2026
- Organization subpart
- No
NPPES NPI Registry
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Community/Retail Pharmacy | 3336C0003X | 29001 | TX | Primary |
Addresses
Primary practice location
621 N Expressway 77
Harlingen, TX 78552-5202
Mailing address
1 Customer Dr
Ms 0445
Bentonville, AR 72716-0445
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851715999 | Medicaid | TX | |
| 470269 | Medicaid | TX | |
| 2144241 | Other | PK |
Other names 1
- Sam's Club Pharmacy 10-6269
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121015000528 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 7012038581 | This NPI is an additional NPI on the enrollment |
| O20140424000225 | TX | DME Supplier - Pharmacy | 7012038581 | Practice locations: Harlingen, TX |
National Provider Directory
National Provider Directory- Tax ID family
- Sams Club Optical
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Sam's Club Optical 30-8268
- Eyewear Supplier
- North Richland Hills, TX
- NPI 1871682716
Member of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Sams Pharmacy 10-6254
- Community/Retail Pharmacy
- Maple Grove, MN
- NPI 1184641581
Member Of
-
dba Walmart Pharmacy 10-1588
- Community/Retail Pharmacy
- Victorville, CA
- NPI 1043237456
Member Of
Locations
621 N Expressway 77
Harlingen, TX 78552
Phone (956) 507-7305
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391990400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1781481600000",
"number": "1851715999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CUSTOMER DR",
"address_2": "MS 0445",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727160445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 N EXPRESSWAY 77",
"city": "HARLINGEN",
"state": "TX",
"postal_code": "785525202",
"telephone_number": "956-507-7305",
"fax_number": "956-507-7316"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAMS EAST INC",
"organizational_subpart": "NO",
"enumeration_date": "2014-02-10",
"last_updated": "2026-06-15",
"certification_date": "2026-06-15",
"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": "NU",
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "TX",
"license": "29001",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1851715999",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "470269",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2144241",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "Ability Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Sam's Club Pharmacy 10-6269",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Harlingen, TX
- Miquel Alfred Salsa, PT, DPT
- Salvador J. Garcia (Rio Grande Family Services, Ltd.)
- Kathleen Ann Salvatore, M.D.
- Sam's East, Inc. (Sam's Optical Center 30-6269)
- Jessica Idalia Samano, RN
- Samuel Landero MD PA
- Sandeep Thomas Samuel, MD
- San Benito Medical Associates, PLLC
- Monica Magali Sanchez-Lucio, LMSW
- Adam James Sanchez, RD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.