WALGREEN CO.
NPI 1144968579
Clinical Medical Laboratory in Herrin, IL

Active since May 25, 2022CLIA 14D2037876 · Waiver
1606 S PARK AVE, HERRIN, IL 62948(618) 942-5291(618) 942-5469 Get Directions Write a Review

NPPES record last updated: May 25, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Walgreen Co. NPPES

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

WALGREEN CO. (NPI 1144968579), doing business as Walgreens #12089, is a healthcare organization registered as a clinical medical laboratory in Herrin, Illinois and active in the NPI registry since May 2022. The organization holds a CLIA Waiver certificate valid through April 6, 2027 and lists Kira L Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1144968579
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameWALGREEN CO.
Location Address1606 S PARK AVEHerrin, IL 62948-4169
Mailing Address1901 E Voorhees St # Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Fax(618) 942-5469
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira L TaylorManager · (217) 709-2351
Enumeration DateMay 25, 2022
NPPES CertifiedMay 25, 2022
NPI 1144968579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition

(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

1606 S PARK AVE, Herrin, IL 62948

Other Names 1

Doing Business AsWalgreens #12089

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 14D2037876

Walgreens #12089 · Herrin, IL
Active · expires Apr 6, 2027
CLIA Number14D2037876
Laboratory TypePharmacy
Certificate Effective DateApril 7, 2025
Certificate Expiration DateApril 6, 2027
Laboratory DirectorBergandi R. Carley
Laboratory Phone(618) 942-5291
Laboratory LocationWalgreens #120891606 S Park Ave, Herrin, IL 62948
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 #12089 carries, from the Medicare DMEPOS supplier directory.

Walgreens #12089

DMEPOS supplier · Herrin, ILOperated by Walgreen Co

Accepts Medicare assignment

Walgreens #12089 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)20385995
Medicare Participant SinceMarch 1, 2022
Supplier Location1606 S Park AveHerrin, IL 62948
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 5

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

Pharmacist
1606 S PARK AVE
HERRIN, IL 62948
Pharmacist
1606 S PARK AVE
HERRIN, IL 62948
Pharmacist
1606 S PARK AVE
HERRIN, IL 62948
Pharmacy
1606 S PARK AVE
HERRIN, IL 62948
Pharmacist
1606 S PARK AVE
HERRIN, IL 62948

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 1144968579. It was assigned to this organization in the NPPES registry on May 25, 2022. The provider is doing business as Walgreens #12089.

Where is Walgreen Co. located?

Walgreen Co. is located at 1606 S Park Ave, Herrin, IL 62948. The listed phone number is (618) 942-5291.

What is Walgreen Co.'s specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Walgreen Co. accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Walgreens #12089 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 14D2037876) is associated with this NPI, valid through April 6, 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 Walgreen Co. was last updated on May 25, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.