WALMART PHARMACY 10-0915 – Community/Retail Pharmacy, NPI 1720005960

WALMART PHARMACY 10-0915 is a healthcare provider. based in Bentonville, Arkansas. specializing in Community/Retail Pharmacy. The organization holds a License No. 21598 (TX). The NPI Number for WALMART PHARMACY 10-0915 is 1720005960

Main info

Organization
Name
WALMART PHARMACY 10-0915
NPI
1720005960
Phone
(479) 277-1238
Address
702 SW 8TH ST
Authorized Official
KIMBERLY CANONIC SENIOR DIRECTOR, ENROLLMENT
Enumeration Date
16 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 10-0915

  • 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, 11210, West Airport Boulevard, Stafford, Fort Bend County, Texas, 77477, United States

    STAFFORD, TX 774773068

    Phone: (281) 933-5252

    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 2024-03-31 (800 days ago).

Enrollment records

1

Earliest due date

2024-03-31

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
O20100930096660OPharmacyTX2024-03-31

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 count12615$0
G0008Administration of influenza virus vaccine5252$0
90662Influenza vaccine split virus, preservative free4747$0
G0009Administration of pneumococcal vaccine2222$0
90677Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use2121$0
View full utilization report →

Insurance plans in this area (ZIP 72716)

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Reviews

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Frequently asked questions

Can I verify WALMART PHARMACY 10-0915 with an NPI only?
You can start verification with NPI 1720005960 for WALMART PHARMACY 10-0915, then check state licensing separately.
Is WALMART PHARMACY 10-0915 listed as active for patients and plans?
The listing shows WALMART PHARMACY 10-0915 as active in the NPI system.
What is WALMART PHARMACY 10-0915's specialty?
The listing groups WALMART PHARMACY 10-0915 with Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Does WALMART PHARMACY 10-0915 list a practice location?
Patients near Bentonville, Arkansas may find WALMART PHARMACY 10-0915 in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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