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WALGREENS
NPI 1053694158
Pharmacist in O Fallon, MO

Active since September 25, 2011CLIA Certified · 2 labs
106 HUNTINGTON CROSSING DR, O FALLON, MO 63376(636) 978-8581 Get Directions Write a Review

NPPES record last updated: September 25, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Walgreens NPPES

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

WALGREENS (NPI 1053694158) is a healthcare organization registered as a pharmacist in O Fallon, Missouri and active in the NPI registry since September 2011. The organization holds 2 active CLIA laboratory certificates and lists Kevin Christopher Hodges, Pharmacist, as its authorized official.

NPPES Registry Identity

NPI1053694158
Entity TypeOrganization
Primary Taxonomy183500000X
Legal Business NameWALGREENS
Location Address106 HUNTINGTON CROSSING DRO Fallon, MO 63376-4271
Mailing Address1490 Mexico Loop Rd EO Fallon, MO 63366-6015 · (636) 978-1602 · Fax (636) 978-8432
Phone(636) 978-8581
Organization SubpartNo
Authorized OfficialKevin Christopher HodgesPharmacist · (636) 978-8581
Enumeration DateSeptember 25, 2011
✔ NPI 1053694158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License✔ Licensed in MO · 043353
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
106 HUNTINGTON CROSSING DR, O Fallon, MO 63376
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

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 26D2012983

Walgreens #05748 · O Fallon, MO
Active · expires Sep 20, 2027
CLIA Number26D2012983
Laboratory TypePharmacy
Certificate Effective DateSeptember 21, 2025
Certificate Expiration DateSeptember 20, 2027
Laboratory DirectorAmanda L. Updegraff
Laboratory Phone(636) 978-1602
Laboratory LocationWalgreens #057481490 Mexico Loop Rd, E, O Fallon, MO 63366
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 26D2056481

Walgreens #06286 · Ofallon, MO
Active · expires Mar 22, 2027
CLIA Number26D2056481
Laboratory TypePharmacy
Certificate Effective DateMarch 23, 2025
Certificate Expiration DateMarch 22, 2027
Laboratory DirectorLisa Houston
Laboratory Phone(636) 379-4131
Laboratory LocationWalgreens #062869495 Mexico Rd, Ofallon, MO 63366
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Walgreens's NPI number?

The NPI number for Walgreens is 1053694158. It was assigned to this organization in the NPPES registry on September 25, 2011.

Where is Walgreens located?

Walgreens is located at 106 Huntington Crossing Dr, O Fallon, MO 63376. The listed phone number is (636) 978-8581.

What is Walgreens's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

Does Walgreens hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Walgreens was last updated on September 25, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.