SAMS EAST INC
NPI 1164870366
Pharmacy - Community/Retail Pharmacy in Wake Forest, NC

Q: What is Sams East Inc's NPI number?

The NPI number for Sams East Inc is 1164870366. It was assigned to this organization in the NPPES registry on May 27, 2016. The provider is doing business as Sam's Pharmacy 10-6976.

Q: 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.

Q: When was this NPI record last updated?

The NPPES record for Sams East Inc was last updated on June 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since May 27, 2016CLIA 34D2115502 · Waiver

11460 ROYALL COTTON ROAD, WAKE FOREST, NC 27587(919) 263-6124(919) 263-6123 Get Directions Write a Review

NPPES record last updated: June 9, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 9, 2025, Feb 6, 2017, Nov 15, 2016 and 1 more (4 updates tracked since 2016).

On this page

About Sams East Inc NPPES

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

SAMS EAST INC (NPI 1164870366), doing business as Sam's Pharmacy 10-6976, is a healthcare organization registered as a community/retail pharmacy in Wake Forest, North Carolina and active in the NPI registry since May 2016. The organization holds a CLIA Waiver certificate valid through July 7, 2028 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1164870366

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameSAMS EAST INC

Location Address11460 ROYALL COTTON ROADWake Forest, NC 27587-0000

Mailing Address702 Sw 8th St, Mailstop 0445Bentonville, AR 72716-0445 · (479) 204-8550 · Fax (479) 204-1258

Phone(919) 263-6124

Fax(919) 263-6123

Organization SubpartNo

Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 277-6348

Enumeration DateMay 27, 2016

Last NPPES UpdateJune 9, 20254 updates tracked since enumeration

NPPES CertifiedJune 9, 2025

✔ NPI 1164870366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

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

Also ListedPharmacyTaxonomy 333600000X

11460 ROYALL COTTON ROAD, Wake Forest, NC 27587

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Other Names 1

Doing Business AsSam's Pharmacy 10-6976

Other Identifiers 2

Medicaid1164870366 NPINC

Other2160527Pk

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 ›

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 34D2115502

Sam's East, Inc Dba Sam's Club Pharmacy 10-6976 · Wake Forest, NC

Active · expires Jul 7, 2028

CLIA Number34D2115502

Laboratory TypePharmacy

Certificate Effective DateJuly 8, 2026

Certificate Expiration DateJuly 7, 2028

Laboratory DirectorJohn D. Chitla

Laboratory Phone(919) 263-6124

Laboratory LocationSam's East, Inc Dba Sam's Club Pharmacy 10-697611460 Royall Cotton Road, Wake Forest, NC 27587

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

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.

222 services221 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.

209 services209 patients

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Sam's Pharmacy 10-6976 carries, from the Medicare DMEPOS supplier directory.

Sam's Pharmacy 10-6976

DMEPOS supplier · Wake Forest, NCOperated by Sam's East, Inc.

⋮

Does not accept Medicare assignment

Sam's Pharmacy 10-6976 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)20514377

Medicare Participant SinceMay 15, 2013

Supplier Location11460 Royall Cotton RdWake Forest, NC 27587

Phone(919) 263-6124

Supplier Specialties

Pharmacy Optician

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

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

SAM'S EAST, INC.

Eyewear Supplier

11460 ROYALL COTTON ROAD
WAKE FOREST, NC 27587

Wake County (919) 263-6120

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 1164870366. It was assigned to this organization in the NPPES registry on May 27, 2016. The provider is doing business as Sam's Pharmacy 10-6976.

Where is Sams East Inc located?

Sams East Inc is located at 11460 Royall Cotton Road, Wake Forest, NC 27587. The listed phone number is (919) 263-6124.

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 10-6976 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 34D2115502) is associated with this NPI, valid through July 7, 2028. 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 47 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 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.