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WALGREEN CO
NPI 1013264670
Pharmacy in Myrtle Beach, SC

Active since August 13, 2012CLIA 42D2062334 · Waiver
1110 DICK POND RD, MYRTLE BEACH, SC 29575(843) 232-0091(843) 232-0097 Get Directions Write a Review

NPPES record last updated: June 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 25, 2025, Apr 21, 2022, Oct 31, 2016 and 2 more (5 updates tracked since 2016).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1013264670), doing business as Walgreens #13995, is a healthcare organization registered as a pharmacy in Myrtle Beach, South Carolina and active in the NPI registry since August 2012. The organization holds a CLIA Waiver certificate valid through March 10, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1013264670
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address1110 DICK POND RDMyrtle Beach, SC 29575-5503
Mailing Address1901 E Voorhees St # Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Phone(843) 232-0091
Fax(843) 232-0097
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateAugust 13, 2012
Last NPPES UpdateJune 25, 20255 updates tracked since enumeration
NPPES CertifiedJune 25, 2025
✔ NPI 1013264670 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in SC · 14284
Definition
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
1110 DICK POND RD, Myrtle Beach, SC 29575
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Other Names 1

Doing Business AsWalgreens #13995

Other Identifiers 2

Other4230912SC · Ncpdp
Medicaid715808SC

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 ›

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 42D2062334

Walgreens #13995 · Myrtle Beach, SC
Active · expires Mar 10, 2027
CLIA Number42D2062334
Laboratory TypePharmacy
Certificate Effective DateMarch 11, 2025
Certificate Expiration DateMarch 10, 2027
Laboratory DirectorLaruen Durst
Laboratory Phone(843) 232-0091
Laboratory LocationWalgreens #139951110 Dick Pond Road, Myrtle Beach, SC 29575
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #13995 carries, from the Medicare DMEPOS supplier directory.

Walgreens #13995

DMEPOS supplier · Myrtle Beach, SCOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #13995 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20384477
Medicare Participant SinceMarch 1, 2022
Supplier Location1110 Dick Pond RdMyrtle Beach, SC 29575
Phone(843) 232-0091
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

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

SHANNON HENDERSON
Pharmacist
1110 DICK POND RD
MYRTLE BEACH, SC 29575
Horry County (843) 232-0091

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 Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1013264670. It was assigned to this organization in the NPPES registry on August 13, 2012. The provider is doing business as Walgreens #13995.

Where is Walgreen Co located?

Walgreen Co is located at 1110 Dick Pond Rd, Myrtle Beach, SC 29575. The listed phone number is (843) 232-0091.

What is Walgreen Co's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Walgreen Co accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Walgreens #13995 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Walgreen Co hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2062334) is associated with this NPI, valid through March 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Walgreen Co 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 38 other insurers list Walgreen Co 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 Walgreen Co was last updated on June 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.