WAL-MART PHARMACY 10-2149 – Community/Retail Pharmacy, NPI 1457378648

WAL-MART PHARMACY 10-2149 is a healthcare provider. based in Mount vernon, Ohio. specializing in Community/Retail Pharmacy. The organization holds a License No. 020789450 (OH). The NPI Number for WAL-MART PHARMACY 10-2149 is 1457378648

Main info

Organization
Name
WAL-MART PHARMACY 10-2149
NPI
1457378648
Phone
(740) 392-3890
Address
1575 COSHOCTON AVE
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 WAL-MART PHARMACY 10-2149

  • 1575 COSHOCTON AVE

    MOUNT VERNON, OH 430501476

    Phone: (740) 392-3890

    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 2024-02-29 (832 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
O20100930035349OPharmacyOH2024-02-29

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
G0008Administration of influenza virus vaccine245244$0
90662Influenza vaccine split virus, preservative free239238$0
90480Admn sarscov2 vacc 1 dose145145$0
91322Sarscov2 vac 50 mcg/0.5ml im139139$0
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count12319$0
View full utilization report →

Insurance plans in this area (ZIP 43050)

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Reviews

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Frequently asked questions

Can I use this page to confirm WAL-MART PHARMACY 10-2149's NPI?
Yes. WAL-MART PHARMACY 10-2149 is listed with NPI 1457378648 in the public NPI dataset.
Does the file indicate WAL-MART PHARMACY 10-2149 is practicing under active NPI?
Directory data currently reports WAL-MART PHARMACY 10-2149 as active.
What taxonomy line describes WAL-MART PHARMACY 10-2149?
For research purposes, treat WAL-MART PHARMACY 10-2149 as Community/Retail Pharmacy in this dataset. Clinical services aligned with this taxonomy classification.
What area does WAL-MART PHARMACY 10-2149 serve?
WAL-MART PHARMACY 10-2149's listing highlights Mount Vernon, Ohio; more addresses can appear in NPPES.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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