Walmart Pharmacy 10-1628 – Community/Retail Pharmacy, NPI 1427075605

Walmart Pharmacy 10-1628 is a healthcare provider. based in Sandusky, Ohio. specializing in Community/Retail Pharmacy. The organization holds a License No. 020646150 (OH). The NPI Number for Walmart Pharmacy 10-1628 is 1427075605

Main info

Organization
Name
Walmart Pharmacy 10-1628
NPI
1427075605
Phone
(419) 627-8283
Address
5500 MILAN RD STE 200
Authorized Official
KIMBERLY CANONIC SENIOR DIRECTOR, ENROLLMENT
Enumeration Date
16 July 2006
Last Update Date
11 July 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

Provider Addresses for Walmart Pharmacy 10-1628

  • 5500 MILAN RD STE 200

    SANDUSKY, OH 448707804

    Phone: (419) 627-8283

    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 2024-03-31 (806 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
O20100930057269OPharmacyOH2024-03-31

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 count94887$0
G0008Administration of influenza virus vaccine152150$0
90662Influenza vaccine split virus, preservative free144142$0
90480Admn sarscov2 vacc 1 dose117117$0
91322Sarscov2 vac 50 mcg/0.5ml im112112$0
View full utilization report →

Insurance plans in this area (ZIP 44870)

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Reviews

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Frequently asked questions

Does Walmart Pharmacy 10-1628 share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Walmart Pharmacy 10-1628 uses 1427075605.
Does the file indicate Walmart Pharmacy 10-1628 is practicing under active NPI?
Directory data currently reports Walmart Pharmacy 10-1628 as active.
What healthcare role does Walmart Pharmacy 10-1628 hold?
Scheduling teams often label Walmart Pharmacy 10-1628 under Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Where is Walmart Pharmacy 10-1628 based?
Walmart Pharmacy 10-1628 is tied to Sandusky, Ohio in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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