WALGREENS #19614
NPI 1093234080
Pharmacy in Vienna, WV

Q: What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1093234080. It was assigned to this organization in the NPPES registry on September 12, 2017. The provider is doing business as Walgreens #19614.

Q: What is Walgreen Co's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Walgreen Co was last updated on June 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since September 12, 2017CLIA 51D2234001 · Waiver

2300 GRAND CENTRAL AVE, VIENNA, WV 26105(304) 295-4573(304) 295-0157 Get Directions Write a Review

NPPES record last updated: June 9, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 9, 2022, Feb 21, 2022, Feb 18, 2022 and 3 more (6 updates tracked since 2017).

On this page

About Walgreens #19614 NPPES

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

WALGREENS #19614 (NPI 1093234080) is a healthcare organization registered as a pharmacy in Vienna, West Virginia and active in the NPI registry since September 2017. The organization holds a CLIA Waiver certificate valid through August 26, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1093234080

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address2300 GRAND CENTRAL AVEVienna, WV 26105-1347

Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344

Phone(304) 295-4573

Fax(304) 295-0157

Organization SubpartYesParent: Walgreens Boots Alliance Inc

Authorized OfficialKira TaylorManager · (217) 709-2351

Enumeration DateSeptember 12, 2017

Last NPPES UpdateJune 9, 20226 updates tracked since enumeration

NPPES CertifiedJune 9, 2022

✔ NPI 1093234080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

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

2300 GRAND CENTRAL AVE, Vienna, WV 26105

Open in Google Maps ↗

Other Names 1

Doing Business AsWalgreens #19614

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 51D2234001

Walgreens #19614 · Vienna, WV

Active · expires Aug 26, 2027

CLIA Number51D2234001

Laboratory TypePharmacy

Certificate Effective DateAugust 27, 2025

Certificate Expiration DateAugust 26, 2027

Laboratory DirectorChedae Jasmine Blackwell

Laboratory Phone(304) 295-4573

Laboratory LocationWalgreens #196142300 Grand Central Avenue, Vienna, WV 26105

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 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.

256 services256 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.

166 services166 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.

79 services79 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.

27 services27 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.

27 services27 patients

Leave this field empty

Other Providers at the Same Location NPPES 9

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

PATRICIA KWARTENGMAA BAIDOO PHARMD

Pharmacist