WALMART PHARMACY 10-3307 – Community/Retail Pharmacy, NPI 1922040765

WALMART PHARMACY 10-3307 is a healthcare provider. based in Bentonville, Arkansas. specializing in Community/Retail Pharmacy. The organization holds a License No. PH22017 (FL). The NPI Number for WALMART PHARMACY 10-3307 is 1922040765

Main info

Organization
Name
WALMART PHARMACY 10-3307
NPI
1922040765
Phone
Not provided
Address
702 SW 8TH ST
Authorized Official
KIMBERLY CANONIC SENIOR DIRECTOR, ENROLLMENT
Enumeration Date
12 June 2006
Last Update Date
19 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 10-3307

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

    BENTONVILLE, AR 727160445

    Phone:

    Type: Mailing

  • Walmart Supercenter, 35, Mike Stewart Drive, Crawfordville, Wakulla County, Florida, 32327, United States

    CRAWFORDVILLE, FL 323271164

    Phone: (850) 926-2881

    Fax: (479) 277-4331

    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 (801 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
O20100930069606OPharmacyFL2024-03-31

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 count1,360154$0
G0008Administration of influenza virus vaccine5858$0
90662Influenza vaccine split virus, preservative free5454$0
91322Sarscov2 vac 50 mcg/0.5ml im3232$0
90480Admn sarscov2 vacc 1 dose3232$0
View full utilization report →

Insurance plans in this area (ZIP 72716)

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Reviews

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Frequently asked questions

How do payers reference WALMART PHARMACY 10-3307?
For WALMART PHARMACY 10-3307, use NPI 1922040765 as the unique 10-digit identifier.
Is there an active status for WALMART PHARMACY 10-3307?
For scheduling context, WALMART PHARMACY 10-3307 is shown as active in the registry.
What kind of doctor is WALMART PHARMACY 10-3307?
WALMART PHARMACY 10-3307 is associated with Community/Retail Pharmacy in the directory — Clinical services aligned with this taxonomy classification.
Is WALMART PHARMACY 10-3307 associated with Bentonville?
Public fields place WALMART PHARMACY 10-3307 around Bentonville, Arkansas. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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