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WALMART INC.
NPI 1629481395
Pharmacy - Community/Retail Pharmacy in Russellville, AR

Active since June 10, 2014CLIA 04D2139518 · Waiver
2109 W MAIN ST, RUSSELLVILLE, AR 72801(479) 498-9540(479) 498-9543 Get Directions Write a Review

NPPES record last updated: August 29, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 29, 2023, Feb 27, 2018, Feb 17, 2017 and 1 more (4 updates tracked since 2015).

About Walmart Inc. NPPES

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

WALMART INC. (NPI 1629481395) is a healthcare organization registered as a community/retail pharmacy in Russellville, Arkansas and active in the NPI registry since June 2014. The organization holds a CLIA Waiver certificate valid through November 5, 2027 and lists Sarah Little, Director Of Healthcare Contracting, as its authorized official.

NPPES Registry Identity

NPI1629481395
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWALMART INC.
Location Address2109 W MAIN STRussellville, AR 72801-4636
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 277-1242 · Fax (479) 277-4331
Phone(479) 498-9540
Fax(479) 498-9543
Organization SubpartNo
Authorized OfficialSarah LittleDirector Of Healthcare Contracting · (479) 277-2500
Enumeration DateJune 10, 2014
Last NPPES UpdateAugust 29, 20234 updates tracked since enumeration
NPPES CertifiedAugust 29, 2023
✔ NPI 1629481395 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 AR · AR20754
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
2109 W MAIN ST, Russellville, AR 72801
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Other Identifiers 2

Other2146634Pk
Medicaid204616407AR

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 Arizona Complete Health and more.Insurance ›

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 04D2139518

Walmart Pharmacy 10-4128 · Russellville, AR
Active · expires Nov 5, 2027
CLIA Number04D2139518
Laboratory TypePharmacy
Certificate Effective DateNovember 6, 2025
Certificate Expiration DateNovember 5, 2027
Laboratory DirectorMr. Randy Stayton
Laboratory Phone(479) 498-9540
Laboratory LocationWalmart Pharmacy 10-41282109 W Main Street, Russellville, AR 72801
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.
106 services104 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.
103 services103 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.
21 services21 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.
11 services11 patients

Medical Equipment Supplier Medicare DMEPOS 11

Medicare supplier enrollment and the product categories Walmart Pharmacy 10-4128 carries, from the Medicare DMEPOS supplier directory.

Walmart Pharmacy 10-4128

DMEPOS supplier · Russellville, AROperated by Walmart Inc
⋮

Does not accept Medicare assignment

Walmart Pharmacy 10-4128 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20444021
Medicare Participant SinceJanuary 1, 2019
Supplier Location2109 W Main StRussellville, AR 72801
Phone(479) 498-9540
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 2

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

THOMAS MATTHEW WILKINS
Pharmacist
2109 W MAIN ST
RUSSELLVILLE, AR 72801
Pope County (479) 498-9540
QINMI AMY WANG PHARMACIST
Pharmacist
2109 W MAIN ST
RUSSELLVILLE, AR 72801
Pope County (479) 498-9540

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 Walmart Inc.'s NPI number?

The NPI number for Walmart Inc. is 1629481395. It was assigned to this organization in the NPPES registry on June 10, 2014.

Where is Walmart Inc. located?

Walmart Inc. is located at 2109 W Main St, Russellville, AR 72801. The listed phone number is (479) 498-9540.

What is Walmart Inc.'s specialty?

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

Does Walmart Inc. accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Walmart Pharmacy 10-4128 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Walmart Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2139518) is associated with this NPI, valid through November 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Walmart Inc. accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 54 other insurers list Walmart Inc. 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 Walmart Inc. was last updated on August 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.