WALMART PHARMACY 10-5455 – Community/Retail Pharmacy, NPI 1326065632

WALMART PHARMACY 10-5455 is a healthcare provider. based in Palm bay, Florida. specializing in Community/Retail Pharmacy. The organization holds a License No. PH21448 (FL). The NPI Number for WALMART PHARMACY 10-5455 is 1326065632

Main info

Organization
Name
WALMART PHARMACY 10-5455
NPI
1326065632
Phone
(321) 723-2101
Address
1040 MALABAR RD SE
Authorized Official
KIMBERLY CANONIC SENIOR DIRECTOR, ENROLLMENT
Enumeration Date
16 July 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
Experience72
Completeness100
Years active:19State licenses:17/7 NPPES fields on file

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Provider Addresses for WALMART PHARMACY 10-5455

  • Walmart Supercenter, 1040, Malabar Road Southeast, Palm Bay, Brevard County, Florida, 32907, United States

    PALM BAY, FL 329073251

    Phone: (321) 723-2101

    Fax: (321) 723-2728

    Type: Location

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

    BENTONVILLE, AR 727160445

    Phone:

    Type: Mailing

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 (798 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
O20100930094584OPharmacyFL2024-03-31

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 count898100$0
G0008Administration of influenza virus vaccine135135$0
90662Influenza vaccine split virus, preservative free125125$0
90480Admn sarscov2 vacc 1 dose8484$0
91322Sarscov2 vac 50 mcg/0.5ml im7474$0
View full utilization report →

Insurance plans in this area (ZIP 32907)

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Reviews

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Frequently asked questions

How do I look up WALMART PHARMACY 10-5455 by NPI?
Use NPI 1326065632 when you need to reference WALMART PHARMACY 10-5455 in forms, claims, or directories.
Is WALMART PHARMACY 10-5455's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize WALMART PHARMACY 10-5455's specialty in plain language?
Clinically, the directory lists WALMART PHARMACY 10-5455 with Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Does WALMART PHARMACY 10-5455 practice in Florida?
You will see Palm Bay, Florida on file for WALMART PHARMACY 10-5455 alongside any extra practice locations.
What if Palm Bay, Florida seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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