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Contact Information

SAMS EAST INC
1460 CORNERSTONE BLVD
DAYTONA BEACH, FL32117
 Phone: 386-760-3078
 Fax: 386-760-3584
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for SAMS EAST INC

NPI Number 1033136445
LBN Legal business name SAMS EAST INC
Authorized official KIMBERLY CANONIC - (SENIOR DIRECTOR, ENROLLMENT)
Entity Organization
Organization subpart 1 Yes
Enumeration date 07/16/2006
Last updated 06/17/2025 - About 12 months ago
Identifiers
FL License # PH19442
FL Medicaid 026239100
FL Medicaid 26239100
Other 2015744 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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