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SAMS EAST INC
NPI 1104266998
Pharmacy - Community/Retail Pharmacy in Owasso, OK

Active since June 26, 2013
12905 E 96TH ST N, OWASSO, OK 74055(918) 212-7041(918) 212-7042 Get Directions Write a Review

NPPES record last updated: June 5, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sams East Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMS EAST INC (NPI 1104266998), doing business as Sam's Pharmacy #10-6238, is a healthcare organization registered as a community/retail pharmacy in Owasso, Oklahoma and active in the NPI registry since June 2013. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1104266998
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSAMS EAST INC
Location Address12905 E 96TH ST NOwasso, OK 74055-4719
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 204-0709 · Fax (479) 277-4331
Phone(918) 212-7041
Fax(918) 212-7042
Organization SubpartYesParent: Wal-mart Stores Inc
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 277-6348
Enumeration DateJune 26, 2013
Last NPPES UpdateJune 5, 2025
NPPES CertifiedJune 5, 2025
✔ NPI 1104266998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in OK · 26358
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
12905 E 96TH ST N, Owasso, OK 74055
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Other Names 1

Doing Business AsSam's Pharmacy #10-6238

Other Identifiers 2

Other2141704Pk
Medicaid100245300BOK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
271 services269 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
254 services254 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
35 services35 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
21 services21 patients

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Sam's Pharmacy 10-6238 carries, from the Medicare DMEPOS supplier directory.

Sam's Pharmacy 10-6238

DMEPOS supplier · Owasso, OKOperated by Sam's East, Inc.
⋮

Does not accept Medicare assignment

Sam's Pharmacy 10-6238 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20514659
Medicare Participant SinceMay 15, 2013
Supplier Location12905 E 96th St NOwasso, OK 74055
Phone(918) 212-7041
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAM'S EAST, INC.
Eyewear Supplier
12905 E 96TH ST N
OWASSO, OK 74055
Tulsa County (479) 204-1258
VALET VISION LLC
Optometrist
12905 E 96TH ST N
OWASSO, OK 74055
Tulsa County (918) 310-2020
BRITTANY CHARLOTTE JONES PHARM. D
Pharmacist
12905 E 96TH ST N
OWASSO, OK 74055
Tulsa County (918) 212-7041
LANA C KELLEY HAD
Hearing Instrument Specialist
12905 E 96TH ST N
OWASSO, OK 74055
Tulsa County (918) 928-2880
HEARING LAB TECHNOLOGY
Hearing Aid Equipment
12905 E 96TH ST N
OWASSO, OK 74055
Tulsa County (405) 308-4973

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sams East Inc's NPI number?

The NPI number for Sams East Inc is 1104266998. It was assigned to this organization in the NPPES registry on June 26, 2013. The provider is doing business as Sam's Pharmacy #10-6238.

Where is Sams East Inc located?

Sams East Inc is located at 12905 E 96th St N, Owasso, OK 74055. The listed phone number is (918) 212-7041.

What is Sams East Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Sams East Inc accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Sam's Pharmacy 10-6238 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

What insurance does Sams East Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 51 other insurers list Sams East Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sams East Inc was last updated on June 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.