WALMART PHARMACY 10-0513 – Community/Retail Pharmacy, NPI 1023035201

WALMART PHARMACY 10-0513 is a healthcare provider. based in Bentonville, Arkansas. specializing in Community/Retail Pharmacy. The organization holds a License No. 21713 (TX). The NPI Number for WALMART PHARMACY 10-0513 is 1023035201

Main info

Organization
Name
WALMART PHARMACY 10-0513
NPI
1023035201
Phone
(479) 277-1242
Address
702 SW 8TH ST
Authorized Official
KIMBERLY CANONIC SENIOR DIRECTOR, ENROLLMENT
Enumeration Date
16 July 2006
Last Update Date
3 June 2025

Contacts

Main Contact
https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness90
Years active:19State licenses:1Updated within 12 months

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Provider Addresses for WALMART PHARMACY 10-0513

  • Walmart Home Office Main Entrance, 702, Southwest 8th Street, Bentonville, Benton County, Arkansas, 72712, United States

    BENTONVILLE, AR 727160445

    Phone: (479) 277-1242

    Type: Mailing

  • Walmart Supercenter, 201, West Marcy Drive, Big Spring, Howard County, Texas, 79720, United States

    BIG SPRING, TX 797202552

    Phone: (432) 267-1585

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Revalidation scheduled

Earliest CMS due date is 2026-10-31 (142 days away).

Enrollment records

1

Earliest due date

2026-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20100930044470OPharmacyTX2026-10-31

What to do next

  • Monitor the published due date as it approaches.
  • Plan to revalidate in PECOS within the window CMS allows before the due date.
  • Verify the date on the CMS Revalidation Lookup Tool before submitting.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0008Administration of influenza virus vaccine9190$0
90662Influenza vaccine split virus, preservative free8281$0
90480Admn sarscov2 vacc 1 dose4545$0
91322Sarscov2 vac 50 mcg/0.5ml im4343$0
G0009Administration of pneumococcal vaccine3232$0
View full utilization report →

Insurance plans in this area (ZIP 72716)

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Reviews

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Frequently asked questions

What identifier follows WALMART PHARMACY 10-0513 across health systems?
The NPI 1023035201 uniquely identifies WALMART PHARMACY 10-0513 in U.S. healthcare data.
Does the public listing show WALMART PHARMACY 10-0513 as active?
WALMART PHARMACY 10-0513's NPI record reflects an active status in NPPES.
What services align with WALMART PHARMACY 10-0513's listing?
WALMART PHARMACY 10-0513's public classification highlights Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
What geographic area is tied to WALMART PHARMACY 10-0513?
WALMART PHARMACY 10-0513 is associated with Bentonville, Arkansas in the same public data insurers reference.
Why is information missing for WALMART PHARMACY 10-0513?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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