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WALMART PHARMACY 10-0861
NPI 1568489706
Pharmacy - Community/Retail Pharmacy in Lubbock, TX

Active since July 16, 2006CLIA 45D2136848 · Waiver
4215 S LOOP 289, LUBBOCK, TX 79423(806) 793-8816 Get Directions Write a Review

NPPES record last updated: August 23, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 23, 2023, Feb 15, 2017, Aug 26, 2016 and 1 more (4 updates tracked since 2015).

About Walmart Pharmacy 10-0861 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALMART PHARMACY 10-0861 (NPI 1568489706) is a healthcare organization registered as a community/retail pharmacy in Lubbock, Texas and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through September 17, 2027 and lists Sarah Little, Director Of Healthcare Contracting, as its authorized official.

NPPES Registry Identity

NPI1568489706
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES TEXAS LLC
Location Address4215 S LOOP 289Lubbock, TX 79423-1100
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 277-1238 · Fax (479) 277-4331
Phone(806) 793-8816
Organization SubpartNo
Authorized OfficialSarah LittleDirector Of Healthcare Contracting · (479) 277-2500
Enumeration DateJuly 16, 2006
Last NPPES UpdateAugust 23, 20234 updates tracked since enumeration
NPPES CertifiedAugust 23, 2023
✔ NPI 1568489706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in TX · 21727
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
4215 S LOOP 289, Lubbock, TX 79423
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Other Names 1

Doing Business AsWalmart Pharmacy 10-0861

Other Identifiers 2

Other2103848Pk
Medicaid470245TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Walmart Pharmacy 10-0861 is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateTexasEnrollment IDO20100930100101DME · PharmacyDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2136848

Walmart Pharmacy 10-0861 · Lubbock, TX
Active · expires Sep 17, 2027
CLIA Number45D2136848
Laboratory TypePharmacy
Certificate Effective DateSeptember 18, 2025
Certificate Expiration DateSeptember 17, 2027
Laboratory DirectorWillliam G. Sherman
Laboratory Phone(806) 793-8816
Laboratory LocationWalmart Pharmacy 10-08614215 S Loop 289, Lubbock, TX 79423
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
159 services157 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
151 services149 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
36 services36 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
36 services36 patients

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR TERRISA DRAKE OD PA
Optometrist
4215 S LOOP 289
LUBBOCK, TX 79423
Lubbock County (806) 535-7052
DANNY CREED AKERS RPH
Pharmacist
4215 S LOOP 289
LUBBOCK, TX 79423
Lubbock County (806) 793-8816
WAL-MART STORES TEXAS, LP
Eyewear Supplier
4215 S LOOP 289
LUBBOCK, TX 79423
Lubbock County (806) 793-2091
DR. BRANDON KYLE BAILEY PHARMD
Pharmacist
4215 S LOOP 289
LUBBOCK, TX 79423
Lubbock County (806) 793-8816
THOMAS ROSS LAWSON
Pharmacist
4215 S LOOP 289
LUBBOCK, TX 79423
Lubbock County (806) 793-8816

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wal-Mart Stores Texas LLC's NPI number?

The NPI number for Wal-Mart Stores Texas LLC is 1568489706. It was assigned to this organization in the NPPES registry on July 16, 2006. The provider is doing business as Walmart Pharmacy 10-0861.

Where is Wal-Mart Stores Texas LLC located?

Wal-Mart Stores Texas LLC is located at 4215 S Loop 289, Lubbock, TX 79423. The listed phone number is (806) 793-8816.

What is Wal-Mart Stores Texas LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Is Wal-Mart Stores Texas LLC enrolled in Medicare?

Yes. Wal-Mart Stores Texas LLC is registered in the Medicare PECOS enrollment system.

When is Wal-Mart Stores Texas LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Texas, Pharmacy) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Wal-Mart Stores Texas LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2136848) is associated with this NPI, valid through September 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Wal-Mart Stores Texas LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 54 other insurers list Wal-Mart Stores Texas LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wal-Mart Stores Texas LLC was last updated on August 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.