WALMART PHARMACY 10-0158
NPI 1871510065
Pharmacy - Community/Retail Pharmacy in Bonham, TX

Active since July 16, 2006CLIA 45D2122870 · Waiver
2021 N HWY 121, BONHAM, TX 75418(903) 583-5564 Get Directions Write a Review

NPPES record last updated: December 1, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 27, 2023, Feb 15, 2017, Aug 25, 2016 and 1 more (4 updates tracked since 2015).

About Walmart Pharmacy 10-0158 NPPES

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

WALMART PHARMACY 10-0158 (NPI 1871510065) is a healthcare organization registered as a community/retail pharmacy in Bonham, Texas and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through December 7, 2026 and lists Matthew Mcmullin, Director Contracting, as its authorized official.Information from the official NPPES registry record, last updated December 1, 2023.

NPPES Registry Identity

NPI1871510065
Entity TypeOrganization
Legal Business NameWAL-MART STORES TEXAS LLC
Location Address2021 N HWY 121Bonham, TX 75418-2340
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 277-1238 · Fax (479) 277-4331
Organization SubpartNo
Authorized OfficialMatthew McmullinDirector Contracting · (479) 371-8711
Enumeration DateJuly 16, 2006
Last NPPES UpdateDecember 1, 20234 updates tracked since enumeration
NPPES CertifiedDecember 1, 2023
NPI 1871510065 is a valid, active identifier and passes the ISO check-digit test. How NPI validation works

Primary Specialty

Pharmacy · Community/Retail Pharmacy

Taxonomy 3336C0003X · Suppliers

Licensed in TX · 21671

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;… Show more

Also Listed

Pharmacy

Taxonomy 333600000X · Suppliers

2021 N HWY 121, Bonham, TX 75418

Also on File with NPPES

Other Names1
Walmart Pharmacy 10-0158 (Doing Business As)
Other Identifiers2
469715 (Medicaid, TX)
2106480 (Other, Pk)

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of influenza virus vaccine

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.

This service was performed 242 times for 240 patients

Administration of pneumococcal vaccine

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.

This service was performed 54 times for 54 patients

Influenza vaccine split virus, preservative free

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.

This service was performed 231 times for 229 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use

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.

This service was performed 54 times for 54 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20609825
Accepts Medicare Assignment
NO
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • 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
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Blood Glucose Monitors/Supplies (Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Enteral Nutrients - Enteral formula
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D2122870
Facility Type
Pharmacy
Certificate Effective Date
December 08, 2024
Certificate Expiration Date
December 07, 2026
Laboratory Director
WARD R. CLEMENTS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Walmart Pharmacy 10-0158 to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for WALMART PHARMACY 10-0158

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1871510065, enumerated as an "organization" on July 16, 2006.

The provider is located at 2021 N HWY 121 BONHAM, TX 75418 and the phone number is (903) 583-5564.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.