WALMART PHARMACY 10-1723 – Community/Retail Pharmacy, NPI 1720005101

WALMART PHARMACY 10-1723 is a healthcare provider. based in Des moines, Iowa. specializing in Community/Retail Pharmacy. The organization holds a License No. 716 (IA). The NPI Number for WALMART PHARMACY 10-1723 is 1720005101

Main info

Organization
Name
WALMART PHARMACY 10-1723
NPI
1720005101
Phone
(515) 287-7748
Address
5101 SE 14TH ST
Authorized Official
KIMBERLY CANONIC SENIOR DIRECTOR, ENROLLMENT
Enumeration Date
16 July 2006
Last Update Date
18 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 10-1723

  • Walmart Supercenter, 5101, Southeast 14th Street, Southeast Plaza, Des Moines, Polk County, Iowa, 50320, United States

    DES MOINES, IA 503201609

    Phone: (515) 287-7748

    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: 2026-06-15

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-02-29 (837 days ago).

Enrollment records

1

Earliest due date

2024-02-29

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
O20100930075947OPharmacyIA2024-02-29

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 count8413$0
G0008Administration of influenza virus vaccine5958$0
90480Admn sarscov2 vacc 1 dose5757$0
91322Sarscov2 vac 50 mcg/0.5ml im5353$0
90662Influenza vaccine split virus, preservative free5353$0
View full utilization report →

Insurance plans in this area (ZIP 50320)

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Reviews

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Frequently asked questions

Is WALMART PHARMACY 10-1723 listed with a National Provider Identifier?
Yes — WALMART PHARMACY 10-1723 has NPI 1720005101 on file in the registry.
Active or inactive — what applies to WALMART PHARMACY 10-1723?
You should see WALMART PHARMACY 10-1723 as active in CMS-hosted NPPES data.
What area of care is associated with WALMART PHARMACY 10-1723?
WALMART PHARMACY 10-1723's record emphasizes Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Is WALMART PHARMACY 10-1723 associated with Des Moines?
Public fields place WALMART PHARMACY 10-1723 around Des Moines, Iowa. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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