WALGREENS #05120
NPI 1093720237
Pharmacy in Des Peres, MO

Active since July 29, 2006CLIA 26D2013045 · Waiver
12006 MANCHESTER RD, DES PERES, MO 63131(314) 965-0030 Get Directions Write a Review

NPPES record last updated: April 25, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 25, 2022, May 11, 2018, Nov 24, 2015 (3 updates tracked since 2015).

About Walgreens #05120 NPPES

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

WALGREENS #05120 (NPI 1093720237) is a healthcare organization registered as a pharmacy in Des Peres, Missouri and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through June 20, 2027 and lists Kira L Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1093720237
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address12006 MANCHESTER RDDes Peres, MO 63131-4415
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira L TaylorManager · (217) 709-2351
Enumeration DateJuly 29, 2006
Last NPPES UpdateApril 25, 20223 updates tracked since enumeration
NPPES CertifiedApril 25, 2022
NPI 1093720237 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in MO · 4479
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
12006 MANCHESTER RD, Des Peres, MO 63131

Other Names 1

Doing Business AsWalgreens #05120

Other Identifiers 4

Medicaid622181808 DMEMO
Medicaid602181802MO
Other2622252Other Id Number-commercial Number
Medicaid61924025365IL

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 26D2013045

Walgreens #05120 · Des Peres, MO
Active · expires Jun 20, 2027
CLIA Number26D2013045
Laboratory TypePharmacy
Certificate Effective DateJune 21, 2025
Certificate Expiration DateJune 20, 2027
Laboratory DirectorEmma L. Shannon
Laboratory Phone(314) 965-0030
Laboratory LocationWalgreens #0512012006 Manchester Rd, Des Peres, MO 63131
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.
579 services575 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.
296 services295 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.
261 services261 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.
49 services49 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.
48 services48 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreen Co carries, from the Medicare DMEPOS supplier directory.

Walgreen Co

DMEPOS supplier · Des Peres, MO

Accepts Medicare assignment

Walgreen Co 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)20357669
Medicare Participant SinceMarch 1, 2022
Supplier Location12006 Manchester RdDes Peres, MO 63131
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 11

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

Pharmacist
12006 MANCHESTER RD
DES PERES, MO 63131
Pharmacist
12006 MANCHESTER RD
SAINT LOUIS, MO 63131
Pharmacist
12006 MANCHESTER RD
DES PERES, MO 63131
Pharmacist
12006 MANCHESTER RD
DES PERES, MO 63131
Pharmacist
12006 MANCHESTER RD
DES PERES, MO 63131
Pharmacist
12006 MANCHESTER RD
DES PERES, MO 63131
Pharmacist
12006 MANCHESTER RD
DES PERES, MO 63131
Pharmacist
12006 MANCHESTER RD
DES PERES, MO 63131

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 1093720237. It was assigned to this organization in the NPPES registry on July 29, 2006.

Where is Walgreen Co located?

Walgreen Co is located at 12006 Manchester Rd, Des Peres, MO 63131. The listed phone number is (314) 965-0030.

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, Walgreen Co 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 26D2013045) is associated with this NPI, valid through June 20, 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 42 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 25, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.