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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

WALGREEN CO
NPI 1083629067
Pharmacy in Newark, NJ

Active since July 29, 2006CLIA 31D2205655 · Waiver
561 IRVINGTON AVE # 579, NEWARK, NJ 07106(973) 373-0387(973) 399-2614 Get Directions Write a Review

NPPES record last updated: July 10, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 10, 2026, Sep 10, 2024, Nov 7, 2023 and 6 more (9 updates tracked since 2015).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1083629067), doing business as Walgreens #03146, is a healthcare organization registered as a pharmacy in Newark, New Jersey and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through December 14, 2026 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1083629067
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address561 IRVINGTON AVE # 579Newark, NJ 07106
Mailing Address1901 E Voorhees St, Ms #790Danville, IL 61834-4509 · (847) 527-2489 · Fax (217) 709-2344
Phone(973) 373-0387
Fax(973) 399-2614
Organization SubpartYesParent: Walgreens Holding Company
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateJuly 29, 2006
Last NPPES UpdateJuly 10, 20269 updates tracked since enumeration
NPPES CertifiedJuly 10, 2026
✔ NPI 1083629067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in NJ · RS003814
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
561 IRVINGTON AVE # 579, Newark, NJ 07106
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Other Names 1

Doing Business AsWalgreens #03146

Other Identifiers 2

Other3127811NJ · Ncpdp
Medicaid4374401NJ

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 31D2205655

Walgreens#03146 · Newark, NJ
Active · expires Dec 14, 2026
CLIA Number31D2205655
Laboratory TypeCovid 19 Test Site
Certificate Effective DateDecember 15, 2024
Certificate Expiration DateDecember 14, 2026
Laboratory DirectorGrace Liu
Laboratory Phone(908) 337-8037
Laboratory LocationWalgreens#03146561-579 Irvington Ave, Newark, NJ 07106
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

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.
59 services58 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.
29 services29 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.
16 services16 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
12 services12 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
12 services12 patients

Other Providers at the Same Location NPPES

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

MR. ALTAF HUSSAIN
Pharmacist
561 IRVINGTON AVE # 579
NEWARK, NJ 07106
Essex County (973) 373-0387

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 1083629067. It was assigned to this organization in the NPPES registry on July 29, 2006. The provider is doing business as Walgreens #03146.

Where is Walgreen Co located?

Walgreen Co is located at 561 Irvington Ave # 579, Newark, NJ 07106. The listed phone number is (973) 373-0387.

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 31D2205655) is associated with this NPI, valid through December 14, 2026. 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 39 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 July 10, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.