Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

WALGREEN CO
NPI 1114932258
Pharmacy in Lansing, MI

Q: What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1114932258. It was assigned to this organization in the NPPES registry on July 29, 2006.

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 August 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 days 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 July 29, 2006CLIA Certified · 2 labs

410 E JOLLY RD, LANSING, MI 48910(517) 882-2389 Get Directions Write a Review

NPPES record last updated: August 3, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 3, 2026, Jun 3, 2026, May 6, 2022 and 1 more (4 updates tracked since 2015).

On this page

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1114932258) is a healthcare organization registered as a pharmacy in Lansing, Michigan and active in the NPI registry since July 2006. The organization holds 2 active CLIA laboratory certificates and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1114932258

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address410 E JOLLY RDLansing, MI 48910-6649

Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344

Phone(517) 882-2389

Organization SubpartYesParent: Walgreens Holding Company

Authorized OfficialJennifer PonceManager · (847) 527-2489

Enumeration DateJuly 29, 2006

Last NPPES UpdateAugust 3, 20264 updates tracked since enumeration

NPPES CertifiedAugust 3, 2026

✔ NPI 1114932258 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in MI · 5301007558

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

410 E JOLLY RD, Lansing, MI 48910

Open in Google Maps ↗

Other Identifiers 3

Medicaid2363872MI

Medicaid4809213 DMEMI

Other2363872Other Id Number-commercial Number

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 23D2011506

Walgreens #06369 · Lansing, MI

Active · expires Aug 9, 2027

CLIA Number23D2011506

Laboratory TypePharmacy

Certificate Effective DateAugust 10, 2025

Certificate Expiration DateAugust 9, 2027

Laboratory DirectorLinda A. Baydoun

Laboratory Phone(517) 882-2732

Laboratory LocationWalgreens #06369410 E Jolly Rd, Lansing, MI 48910

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D2061272

Walgreens #05841 · Lansing, MI

Active · expires Apr 5, 2027

CLIA Number23D2061272

Laboratory TypePharmacy

Certificate Effective DateApril 6, 2025

Certificate Expiration DateApril 5, 2027

Laboratory DirectorRose M. Nyakundi

Laboratory Phone(517) 393-5784

Laboratory LocationWalgreens #058413404 S Martin Luther King Jr Blvd, Lansing, MI 48910

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 2

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.

63 services63 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.

41 services41 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #6369 carries, from the Medicare DMEPOS supplier directory.

Walgreens #6369

DMEPOS supplier · Lansing, MIOperated by Walgreen Co

✔

Accepts Medicare assignment

Walgreens #6369 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)20364113

Medicare Participant SinceMarch 1, 2022

Supplier Location410 E Jolly RdLansing, MI 48910

Phone(517) 882-2732

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 7

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

MS. PATSY GLANTZBERG RPH

Pharmacist