SAMS PHARMACY 10-6217 – Community/Retail Pharmacy, NPI 1922025329

SAMS PHARMACY 10-6217 is a healthcare provider. based in Bentonville, Arkansas. specializing in Community/Retail Pharmacy. The organization holds a License No. PH19252 (FL). The NPI Number for SAMS PHARMACY 10-6217 is 1922025329

Main info

Organization
Name
SAMS PHARMACY 10-6217
NPI
1922025329
Phone
Not provided
Address
702 SW 8TH ST
Authorized Official
KIMBERLY CANONIC SENIOR DIRECTOR, ENROLLMENT
Enumeration Date
16 July 2006
Last Update Date
16 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
Completeness100
Years active:19State licenses:17/7 NPPES fields on file

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Provider Addresses for SAMS PHARMACY 10-6217

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

    BENTONVILLE, AR 727160445

    Phone:

    Type: Mailing

  • Sam's Club, 8425, Northwest 13th Terrace, Doral, Miami-Dade County, Florida, 33126, United States

    DORAL, FL 331261509

    Phone: (305) 463-8475

    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)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

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
O20100930061798OPharmacyFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

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 count22827$0
G0008Administration of influenza virus vaccine1717$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage1414$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 use this page to confirm SAMS PHARMACY 10-6217's NPI?
Yes. SAMS PHARMACY 10-6217 is listed with NPI 1922025329 in the public NPI dataset.
Can I rely on SAMS PHARMACY 10-6217 being an active provider?
As of the registry snapshot, SAMS PHARMACY 10-6217 is marked active.
What taxonomy line describes SAMS PHARMACY 10-6217?
For research purposes, treat SAMS PHARMACY 10-6217 as Community/Retail Pharmacy in this dataset. Clinical services aligned with this taxonomy classification.
Where is SAMS PHARMACY 10-6217 based?
SAMS PHARMACY 10-6217 is tied to Bentonville, Arkansas in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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