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WALGREENS
NPI 1114296050
Pharmacy - Community/Retail Pharmacy in Palm Coast, FL

Active since December 21, 2011CLIA 10D2219277 · Waiver
5000 E HIGHWAY 100, PALM COAST, FL 32164(386) 586-3830(386) 586-5606 Get Directions Write a Review

NPPES record last updated: December 21, 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 1114296050) is a healthcare organization registered as a community/retail pharmacy in Palm Coast, Florida and active in the NPI registry since December 2011. The organization holds a CLIA Waiver certificate valid through April 4, 2027 and lists Srilatha Anumasu, Pharmacist, as its authorized official.

NPPES Registry Identity

NPI1114296050
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWALGREENS
Location Address5000 E HIGHWAY 100Palm Coast, FL 32164-2363
Mailing Address5000 E Highway 100Palm Coast, FL 32164-2363 · (386) 586-3830 · Fax (386) 586-5606
Phone(386) 586-3830
Fax(386) 586-5606
Organization SubpartNo
Authorized OfficialSrilatha AnumasuPharmacist · (386) 586-3830
Enumeration DateDecember 21, 2011
✔ NPI 1114296050 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in FL · PS38551
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
5000 E HIGHWAY 100, Palm Coast, FL 32164
Open in Google Maps ↗

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 10D2219277

Walgreen Co · Palm Coast, FL
Active · expires Apr 4, 2027
CLIA Number10D2219277
Laboratory TypePharmacy
Certificate Effective DateApril 5, 2025
Certificate Expiration DateApril 4, 2027
Laboratory DirectorEreka A. Manangan
Laboratory Phone(386) 586-3830
Laboratory LocationWalgreen Co5000 E Hwy 100, Palm Coast, FL 32164
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #7755 carries, from the Medicare DMEPOS supplier directory.

Walgreens #7755

DMEPOS supplier · Palm Coast, FLOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #7755 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)20354009
Medicare Participant SinceMarch 1, 2022
Supplier Location5000 E Highway 100Palm Coast, FL 32164
Phone(386) 586-3830
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.

PHUONG TRINH PHARMD
Pharmacist
5000 E HIGHWAY 100
PALM COAST, FL 32164
Flagler County (386) 586-3830

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 1114296050. It was assigned to this organization in the NPPES registry on December 21, 2011.

Where is Walgreens located?

Walgreens is located at 5000 E Highway 100, Palm Coast, FL 32164. The listed phone number is (386) 586-3830.

What is Walgreens's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Walgreens accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Walgreens #7755 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Walgreens hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2219277) is associated with this NPI, valid through April 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Walgreens was last updated on December 21, 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.