WALGREEN CO. NPI 1003002254
Pharmacy in Gray, TN
About WALGREEN CO.
Walgreens #11113 is a provider established in Gray, Tennessee operating as a Pharmacy. The NPI number of this provider is 1003002254 and was assigned on September 2007. The practitioner's primary taxonomy code is 333600000X with license number 4444 (TN). The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Walgreens #11113. The authorized official of this NPI record is Kira Taylor (Manager)
| NPI | 1003002254 |
| Provider Name | WALGREEN CO. |
| Location Address | 5104 BOBBY HICKS HWY GRAY, TN 37615 |
| Location Phone | (423) 477-3372 |
| Mailing Address | 1901 E VOORHEES ST MS #790 DANVILLE, IL 61834 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | Yes |
| Other Organization Name | WALGREENS #11113 |
| Other Name Type | Doing Business As (3) |
| Enumeration Date | 09-21-2007 |
| Last Update Date | 04-26-2022 |
The CLIA number of Walgreens #11113 is 44D1086038 registered as a "pharmacy" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Walgreens #11113 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.
Primary Taxonomy
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
| Taxonomy Code | 333600000X |
| Classification | Pharmacy |
| Type | Suppliers |
| License No. | 4444 |
| License State | TN |
| Taxonomy Description | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
5104 BOBBY HICKS HWY
GRAY, TN
ZIP 37615
Phone: (423) 477-3372
Fax: (423) 477-8533
Mailing Address
1901 E VOORHEES ST
MS #790
DANVILLE, IL
ZIP 61834
Phone: (217) 709-2351
Fax: (217) 709-2344
Location Map
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 the NPI number 1003002254 is:
| CLIA Number | 44D1086038 |
| Facility Type | PHARMACY |
| Certificate Type | Certificate of Waiver |
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | No | |||
Taxonomy Description: a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. | |||||||
| 2 | 3336C0003X | Suppliers | Pharmacy | Community/Retail Pharmacy | No | ||
Taxonomy Description: 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. | |||||||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4440664 | OTHER (01) | NCPDP | |
| 4440664 | MEDICAID (05) | TN |
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 0 | 3 | 0 | 0 | 2 | 2 | 5 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 0 | 4 | 2 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 0 + 0 + 4 + 2 + 1 + 0 + 24 = 36 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 40 - 36 = 4 | 4 | ||||||||
The NPI number 1003002254 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1497066609 | MANDY DISHNER PHARM.D. Individual | Pharmacist | 5104 BOBBY HICKS HWY GRAY, TN 37615 (423) 477-3372 |
| 1528379252 | BILLIE REILLY PHARM.D. Individual | Pharmacist | 5104 BOBBY HICKS HWY GRAY, TN 37615 (423) 477-3372 |
| 1770923443 | ABIGAIL BROWN PHARMD Individual | Pharmacist | 5104 BOBBY HICKS HWY GRAY, TN 37615 (423) 477-3372 |
| 1518307917 | ARISSA BROOKE VAUGHN PHARMD Individual | Pharmacist | 5104 BOBBY HICKS HWY GRAY, TN 37615 (423) 477-3372 |
| 1053930420 | DR. MOLLY MARIE KETRON PHARMD Individual | Pharmacist | 5104 BOBBY HICKS HWY JOHNSON CITY, TN 37615 (423) 477-3372 |
Frequently Asked Questions
What is WALGREENS #11113 NPI number?
The NPI number assigned to this healthcare provider is 1003002254, registered as an "organization" on September 21, 2007
Where is WALGREENS #11113 located?
The provider is located at 5104 Bobby Hicks Hwy Gray, Tn 37615 and the phone number is (423) 477-3372
What kind of medical provider is WALGREENS #11113?
This medical organization specializes in Pharmacy
What insurance does WALGREENS #11113 accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
What is WALGREENS #11113 CLIA number?
The provider's CLIA number is 44D1086038 for a "pharmacy" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued 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..
How do I update my NPI information?
The NPI record of WALGREENS #11113 was last updated on September 21, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
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