SAMS EAST INC
NPI 1154763043
Pharmacy - Community/Retail Pharmacy in Raymore, MO

Active since July 22, 2013CLIA 26D2127476 · Waiver
141 N DEAN AVE, RAYMORE, MO 64083(816) 765-0600 Get Directions Write a Review

NPPES record last updated: June 17, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Sams East Inc NPPES

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

SAMS EAST INC (NPI 1154763043), doing business as Sam's Pharmacy 10-8243, is a healthcare organization registered as a community/retail pharmacy in Raymore, Missouri and active in the NPI registry since July 2013. The organization holds a CLIA Waiver certificate valid through March 13, 2027 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1154763043
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSAMS EAST INC
Location Address141 N DEAN AVERaymore, MO 64083-8398
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 277-1242 · Fax (479) 277-4331
Organization SubpartYesParent: Wal-mart Stores Inc
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515
Enumeration DateJuly 22, 2013
Last NPPES UpdateJune 17, 2025
NPPES CertifiedJune 17, 2025
NPI 1154763043 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 MO · 2013037339
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
141 N DEAN AVE, Raymore, MO 64083

Other Names 1

Doing Business AsSam's Pharmacy 10-8243

Other Identifiers 2

Other2141551Pk
Medicaid1154763043MO

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2127476

Sams East, Inc Dba Sam's Pharmacy 10-8243 · Raymore, MO
Active · expires Mar 13, 2027
CLIA Number26D2127476
Laboratory TypePharmacy
Certificate Effective DateMarch 14, 2025
Certificate Expiration DateMarch 13, 2027
Laboratory DirectorBridget Colombo
Laboratory Phone(816) 425-9373
Laboratory LocationSams East, Inc Dba Sam's Pharmacy 10-8243141 N Dean Ave, Raymore, MO 64083
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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.
216 services215 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.
208 services208 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.
13 services13 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.
13 services13 patients

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Sam's Pharmacy #10-8243 carries, from the Medicare DMEPOS supplier directory.

Sam's Pharmacy #10-8243

DMEPOS supplier · Raymore, MOOperated by Sam's East, Inc.

Does not accept Medicare assignment

Sam's Pharmacy #10-8243 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)20514725
Medicare Participant SinceMay 15, 2013
Supplier Location141 N Dean AveRaymore, MO 64083
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 4

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

Pharmacist
141 N DEAN AVE
RAYMORE, MO 64083
Hearing Instrument Specialist
141 N DEAN AVE
RAYMORE, MO 64083
Pharmacist
141 N DEAN AVE
RAYMORE, MO 64083
Pharmacist
141 N DEAN AVE
RAYMORE, MO 64083

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 1154763043. It was assigned to this organization in the NPPES registry on July 22, 2013. The provider is doing business as Sam's Pharmacy 10-8243.

Where is Sams East Inc located?

Sams East Inc is located at 141 N Dean Ave, Raymore, MO 64083. The listed phone number is (816) 765-0600.

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 #10-8243 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.

Does Sams East Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2127476) is associated with this NPI, valid through March 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 50 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 17, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.