1. Home
  2. Directory
  3. Georgia
  4. Dacula
  5. Pharmacy
  6. NPI Profile

RITE AID #11686
NPI 1023531845
Pharmacy in Dacula, GA

Active since July 24, 2017CLIA 11D2034219 · Waiver
2580 WINDER HWY, DACULA, GA 30019(770) 682-0213(770) 682-4371 Get Directions Write a Review

NPPES record last updated: April 27, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 27, 2018, Jul 24, 2017 (2 updates tracked since 2017).

About Rite Aid #11686 NPPES

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

RITE AID #11686 (NPI 1023531845) is a healthcare organization registered as a pharmacy in Dacula, Georgia and active in the NPI registry since July 2017. The organization holds a CLIA Waiver certificate valid through October 26, 2026 and lists Alyssa Sweeten, Manager, as its authorized official.

NPPES Registry Identity

NPI1023531845
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address2580 WINDER HWYDacula, GA 30019-1328
Mailing Address1901 E Voorhees St # Ms 790Danville, IL 61834-4509 · (217) 709-2386 · Fax (217) 709-2344
Phone(770) 682-0213
Fax(770) 682-4371
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialAlyssa SweetenManager · (217) 709-2386
Enumeration DateJuly 24, 2017
Last NPPES UpdateApril 27, 20182 updates tracked since enumeration
✔ NPI 1023531845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in GA · PHRE010470
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
2580 WINDER HWY, Dacula, GA 30019
Open in Google Maps ↗

Other Names 1

Doing Business AsRite Aid #11686

Other Identifiers 2

Other1170353GA · Ncpdp
Medicaid000027035EGA

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 11D2034219

Walgreen#12147 · Dacula, GA
Active · expires Oct 26, 2026
CLIA Number11D2034219
Laboratory TypeCovid Testing Site
Certificate Effective DateOctober 27, 2024
Certificate Expiration DateOctober 26, 2026
Laboratory DirectorChanthakhone Juarez
Laboratory Phone(770) 547-6508
Laboratory LocationWalgreen#12147575 Dacula Road, Dacula, GA 30019
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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.

TAMMY L CARLOSS
Pharmacist
2580 WINDER HWY
DACULA, GA 30019
Gwinnett County (770) 682-0213
HALA MUHANNA PHARM.D.
Pharmacist
2580 WINDER HWY
DACULA, GA 30019
Gwinnett County (770) 682-0213

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 1023531845. It was assigned to this organization in the NPPES registry on July 24, 2017. The provider is doing business as Rite Aid #11686.

Where is Walgreen Co located?

Walgreen Co is located at 2580 Winder Hwy, Dacula, GA 30019. The listed phone number is (770) 682-0213.

What is Walgreen Co's specialty?

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

Does Walgreen Co hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2034219) is associated with this NPI, valid through October 26, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Walgreen Co was last updated on April 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.