WALMART PHARMACY 10-0759 – Community/Retail Pharmacy, NPI 1689691990

WALMART PHARMACY 10-0759 is a healthcare provider. based in Wauchula, Florida. specializing in Community/Retail Pharmacy. The organization holds a License No. PH15339 (FL). The NPI Number for WALMART PHARMACY 10-0759 is 1689691990

Main info

Organization
Name
WALMART PHARMACY 10-0759
NPI
1689691990
Phone
(863) 773-5900
Address
1480 US HIGHWAY 17 N
Authorized Official
KIMBERLY CANONIC SENIOR DIRECTOR, ENROLLMENT
Enumeration Date
16 July 2006
Last Update Date
3 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

Provider Addresses for WALMART PHARMACY 10-0759

  • 1480 US HIGHWAY 17 N

    WAUCHULA, FL 338735006

    Phone: (863) 773-5900

    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 (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
O20100930095624OPharmacyFL2024-03-31

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 count812117$0
G0008Administration of influenza virus vaccine119118$0
90662Influenza vaccine split virus, preservative free110109$0
91322Sarscov2 vac 50 mcg/0.5ml im8585$0
90480Admn sarscov2 vacc 1 dose8585$0
View full utilization report →

Insurance plans in this area (ZIP 33873)

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Reviews

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Frequently asked questions

What is WALMART PHARMACY 10-0759's NPI number?
WALMART PHARMACY 10-0759's NPI is 1689691990 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to WALMART PHARMACY 10-0759?
You should see WALMART PHARMACY 10-0759 as active in CMS-hosted NPPES data.
What kind of doctor is WALMART PHARMACY 10-0759?
WALMART PHARMACY 10-0759 is associated with Community/Retail Pharmacy in the directory — Clinical services aligned with this taxonomy classification.
Is WALMART PHARMACY 10-0759 associated with Wauchula?
Public fields place WALMART PHARMACY 10-0759 around Wauchula, Florida. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for WALMART PHARMACY 10-0759 is noted as July 16, 2006 where the registry provides it.

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