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WALGREENS #12005
NPI 1104120047
Pharmacy in Santa Fe, NM

Active since January 07, 2011CLIA Certified · 2 labs
5721 AIRPORT RD, SANTA FE, NM 87507(505) 216-1492(505) 216-1498 Get Directions Write a Review

NPPES record last updated: June 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 19, 2024, Oct 14, 2016, Jan 12, 2016 (3 updates tracked since 2016).

About Walgreens #12005 NPPES

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

WALGREENS #12005 (NPI 1104120047) is a healthcare organization registered as a pharmacy in Santa Fe, New Mexico and active in the NPI registry since January 2011. The organization holds 2 active CLIA laboratory certificates and lists Virginia Garza, Manager, as its authorized official.

NPPES Registry Identity

NPI1104120047
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address5721 AIRPORT RDSanta Fe, NM 87507
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2364 · Fax (217) 709-2344
Phone(505) 216-1492
Fax(505) 216-1498
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialVirginia GarzaManager · (217) 709-2364
Enumeration DateJanuary 7, 2011
Last NPPES UpdateJune 19, 20243 updates tracked since enumeration
NPPES CertifiedJune 19, 2024
✔ NPI 1104120047 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in NM · PH00004113
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
5721 AIRPORT RD, Santa Fe, NM 87507
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Other Names 1

Doing Business AsWalgreens #12005

Other Identifiers 2

Other3212090Ncpdp
Medicaid37003569NM

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 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 32D2240849

Walgreens #12005 · Santa Fe, NM
Active · expires Oct 21, 2027
CLIA Number32D2240849
Laboratory TypePharmacy
Certificate Effective DateOctober 22, 2025
Certificate Expiration DateOctober 21, 2027
Laboratory DirectorIfeoma M. Romaine
Laboratory Phone(505) 216-1492
Laboratory LocationWalgreens #120055721 Airport Rd, Santa Fe, NM 87507
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 32D2011752

Walgreens #03934 · Santa Fe, NM
Active · expires Aug 9, 2027
CLIA Number32D2011752
Laboratory TypePharmacy
Certificate Effective DateAugust 10, 2025
Certificate Expiration DateAugust 9, 2027
Laboratory DirectorElizabeth A. Estrada
Laboratory Phone(505) 474-5307
Laboratory LocationWalgreens #039343298 Cerrillos Rd, Santa Fe, NM 87507
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.
250 services246 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.
177 services177 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.
54 services54 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.
26 services26 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.
26 services26 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #12005 carries, from the Medicare DMEPOS supplier directory.

Walgreens #12005

DMEPOS supplier · Sante Fe, NMOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #12005 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)20383715
Medicare Participant SinceMarch 1, 2022
Supplier Location5721 Airport RdSante Fe, NM 87507
Phone(505) 216-1492
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

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

MS. ZIVILE SEAMONS PHARMD
Pharmacist
5721 AIRPORT RD
SANTA FE, NM 87507
Santa Fe County (505) 216-1492

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 1104120047. It was assigned to this organization in the NPPES registry on January 7, 2011. The provider is doing business as Walgreens #12005.

Where is Walgreen Co located?

Walgreen Co is located at 5721 Airport Rd, Santa Fe, NM 87507. The listed phone number is (505) 216-1492.

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 #12005 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Walgreen Co 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.

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 June 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.