WALGREENS #12693
NPI 1043225196
Pharmacy in Appleton, WI

Active since July 29, 2006CLIA 52D2015495 · Waiver
729 W NORTHLAND AVE, APPLETON, WI 54914(920) 954-8100(920) 954-0329 Get Directions Write a Review

NPPES record last updated: April 5, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 5, 2022, Jan 13, 2016 (2 updates tracked since 2016).

About Walgreens #12693 NPPES

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

WALGREENS #12693 (NPI 1043225196) is a healthcare organization registered as a pharmacy in Appleton, Wisconsin and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through April 22, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1043225196
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address729 W NORTHLAND AVEAppleton, WI 54914-1426
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Fax(920) 954-0329
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateJuly 29, 2006
Last NPPES UpdateApril 5, 20222 updates tracked since enumeration
NPPES CertifiedApril 5, 2022
NPI 1043225196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in WI · 8938
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
729 W NORTHLAND AVE, Appleton, WI 54914

Other Names 1

Doing Business AsWalgreens #12693

Other Identifiers 2

Medicaid33189800WI
Other5121328Other Id Number-commercial Number

Accepted 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 52D2015495

Walgreens #12693 · Appleton, WI
Active · expires Apr 22, 2027
CLIA Number52D2015495
Laboratory TypePharmacy
Certificate Effective DateApril 23, 2025
Certificate Expiration DateApril 22, 2027
Laboratory DirectorJudith M. Dudek
Laboratory Phone(920) 954-8100
Laboratory LocationWalgreens #12693729 W Northland Ave, Appleton, WI 54914
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 3

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.
162 services162 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
77 services77 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.
75 services75 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #12693 carries, from the Medicare DMEPOS supplier directory.

Walgreens #12693

DMEPOS supplier · Appleton, WIOperated by Walgreen Co

Accepts Medicare assignment

Walgreens #12693 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)20351021
Medicare Participant SinceMarch 1, 2022
Supplier Location729 W Northland AveAppleton, WI 54914
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 13

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

Pharmacist
729 W NORTHLAND AVE
APPLETON, WI 54914
Pharmacist
729 W NORTHLAND AVE
APPLETON, WI 54914
Pharmacist
729 W NORTHLAND AVE
APPLETON, WI 54914
Pharmacist
729 W NORTHLAND AVE
APPLETON, WI 54914
Pharmacist
729 W NORTHLAND AVE
APPLETON, WI 54914
Pharmacist
729 W NORTHLAND AVE
APPLETON, WI 54914
Pharmacist
729 W NORTHLAND AVE
APPLETON, WI 54914
Pharmacist
729 W NORTHLAND AVE
APPLETON, WI 54914

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 1043225196. It was assigned to this organization in the NPPES registry on July 29, 2006. The provider is doing business as Walgreens #12693.

Where is Walgreen Co located?

Walgreen Co is located at 729 W Northland Ave, Appleton, WI 54914. The listed phone number is (920) 954-8100.

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 #12693 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 52D2015495) is associated with this NPI, valid through April 22, 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 41 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 April 5, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.