WALMART PHARMACY 10-0849 – Community/Retail Pharmacy, NPI 1104844992

WALMART PHARMACY 10-0849 is a healthcare provider. based in Bentonville, Arkansas. specializing in Community/Retail Pharmacy. The organization holds a License No. 21726 (TX). The NPI Number for WALMART PHARMACY 10-0849 is 1104844992

Main info

Organization
Name
WALMART PHARMACY 10-0849
NPI
1104844992
Phone
(479) 277-1238
Address
702 SW 8TH ST
Authorized Official
KIMBERLY CANONIC SENIOR DIRECTOR, ENROLLMENT
Enumeration Date
18 July 2006
Last Update Date
4 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 10-0849

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

    BENTONVILLE, AR 727160445

    Phone: (479) 277-1238

    Fax: (479) 277-4331

    Type: Mailing

  • Walmart Supercenter, 155, Louetta Crossing, Spring, Harris County, Texas, 77373, United States

    SPRING, TX 773733007

    Phone: (281) 651-0216

    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)

Past revalidation due date

Earliest CMS due date was 2023-08-31 (1015 days ago).

Enrollment records

1

Earliest due date

2023-08-31

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
O20100930032573OPharmacyTX2023-08-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count46555$0
G0008Administration of influenza virus vaccine4746$0
90662Influenza vaccine split virus, preservative free4443$0
90677Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use1717$0
90480Admn sarscov2 vacc 1 dose1717$0
View full utilization report →

Insurance plans in this area (ZIP 72716)

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Reviews

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Frequently asked questions

Does WALMART PHARMACY 10-0849 have a public NPI I can cite?
Public records show WALMART PHARMACY 10-0849 under NPI 1104844992.
Should I treat WALMART PHARMACY 10-0849 as an active provider?
Patients and plans typically see WALMART PHARMACY 10-0849 as active in the national extract.
How should patients interpret WALMART PHARMACY 10-0849's specialty?
The extract shows Community/Retail Pharmacy for WALMART PHARMACY 10-0849. Clinical services aligned with this taxonomy classification.
What geographic area is tied to WALMART PHARMACY 10-0849?
WALMART PHARMACY 10-0849 is associated with Bentonville, Arkansas in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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