WALMART PHARMACY 10-0284 – Community/Retail Pharmacy, NPI 1104843218
Community/Retail Pharmacy
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for WALMART PHARMACY 10-0284
930 N WALNUT CREEK DR STE 800
MANSFIELD, TX 760638021
Phone: (817) 473-3014
Type: Location
Walmart Home Office Main Entrance, 702, Southwest 8th Street, Bentonville, Benton County, Arkansas, 72712, United States
BENTONVILLE, AR 727160445
Phone: (479) 277-1238
Fax: (479) 277-4331
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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 (804 days ago).
Enrollment records
1
Earliest due date
2024-03-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100930092321 | O | Pharmacy | TX | 2024-03-31 |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 354 | 40 | $0 |
| G0008 | Administration of influenza virus vaccine | 80 | 80 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 77 | 77 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 35 | 35 | $0 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 35 | 35 | $0 |
Insurance plans in this area (ZIP 76063)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.