WALMART PHARMACY 10-5447 – Community/Retail Pharmacy, NPI 1669414660

WALMART PHARMACY 10-5447 is a healthcare provider. based in Bentonville, Arkansas. specializing in Community/Retail Pharmacy. The organization holds a License No. 28RS00661900 (NJ). The NPI Number for WALMART PHARMACY 10-5447 is 1669414660

Main info

Organization
Name
WALMART PHARMACY 10-5447
NPI
1669414660
Phone
Not provided
Address
702 SW 8TH ST
Authorized Official
KIMBERLY CANONIC SENIOR DIRECTOR, ENROLLMENT
Enumeration Date
12 June 2006
Last Update Date
13 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
Experience67
Completeness100
Years active:19State licenses:17/7 NPPES fields on file

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Provider Addresses for WALMART PHARMACY 10-5447

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

    BENTONVILLE, AR 727160445

    Phone:

    Type: Mailing

  • Walmart Supercenter, 150, Harrison Avenue, Kearny, Hudson County, New Jersey, 07032, United States

    KEARNY, NJ 070325950

    Phone: (201) 955-0162

    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 2026-05-31 (10 days ago).

Enrollment records

1

Earliest due date

2026-05-31

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
O20100930093612OPharmacyNJ2026-05-31

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 count80681$0
G0008Administration of influenza virus vaccine5150$0
90662Influenza vaccine split virus, preservative free4645$0
90480Admn sarscov2 vacc 1 dose4343$0
91322Sarscov2 vac 50 mcg/0.5ml im4343$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 unique ID ties claims to WALMART PHARMACY 10-5447?
NPI 1669414660 is assigned to WALMART PHARMACY 10-5447 under the national enumeration system.
Is WALMART PHARMACY 10-5447 currently active in the NPI registry?
CMS-published data lists WALMART PHARMACY 10-5447 as an active registrant.
What does WALMART PHARMACY 10-5447 treat or focus on?
Patients typically see WALMART PHARMACY 10-5447 under the specialty Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Where does public data place WALMART PHARMACY 10-5447?
The snapshot lists Bentonville, Arkansas for WALMART PHARMACY 10-5447; download NPPES for the complete set.
Is WALMART PHARMACY 10-5447 a real provider?
This page reflects official NPPES data for NPI 1669414660. Always confirm identity and privileges with the practice and licensing boards.

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