SAMS EAST INC
NPI 1902223019
Pharmacy - Community/Retail Pharmacy in Kansas City, MO

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

The NPI number for Sams East Inc is 1902223019. It was assigned to this organization in the NPPES registry on March 26, 2014. The provider is doing business as Sam's Club Pharmacy 10-6247.

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 March 26, 2014CLIA 26D2126153 · Waiver

8130 N CHURCH RD, KANSAS CITY, MO 64158(816) 439-4014(816) 439-4015 Get Directions Write a Review

NPPES record last updated: June 9, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 9, 2025, Jun 13, 2016 (2 updates tracked since 2016).

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About Sams East Inc NPPES

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

SAMS EAST INC (NPI 1902223019), doing business as Sam's Club Pharmacy 10-6247, is a healthcare organization registered as a community/retail pharmacy in Kansas City, Missouri and active in the NPI registry since March 2014. The organization holds a CLIA Waiver certificate valid through February 20, 2027 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1902223019

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameSAMS EAST INC

Location Address8130 N CHURCH RDKansas City, MO 64158-1101

Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 277-1242

Phone(816) 439-4014

Fax(816) 439-4015

Organization SubpartNo

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

Enumeration DateMarch 26, 2014

Last NPPES UpdateJune 9, 20252 updates tracked since enumeration

NPPES CertifiedJune 9, 2025

✔ NPI 1902223019 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 · 2014016142

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

8130 N CHURCH RD, Kansas City, MO 64158

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Other Names 1

Doing Business AsSam's Club Pharmacy 10-6247

Other Identifiers 2

Medicaid1902223019MO

Other2144991Pk

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 26D2126153

Sam's East, Inc Dba Sam's Pharmacy 10-6247 · Kansas City, MO

Active · expires Feb 20, 2027

CLIA Number26D2126153

Laboratory TypePharmacy

Certificate Effective DateFebruary 21, 2025

Certificate Expiration DateFebruary 20, 2027

Laboratory DirectorGretta Bogaard

Laboratory Phone(816) 439-4014

Laboratory LocationSam's East, Inc Dba Sam's Pharmacy 10-62478130 N Church Road, Kansas City, MO 64158

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 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.

254 services254 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.

244 services244 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.

33 services33 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.

33 services33 patients

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Sam's Club Pharmacy #10-6247 carries, from the Medicare DMEPOS supplier directory.

Sam's Club Pharmacy #10-6247

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

⋮

Does not accept Medicare assignment

Sam's Club Pharmacy #10-6247 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)20514419

Medicare Participant SinceMay 15, 2013

Supplier Location8130 N Church RdKansas City, MO 64158

Phone(816) 439-4014

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 5

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

ALLISON HUMPHREYS PHARMD

Pharmacist