WALGREEN CO
NPI 1154336279
Pharmacy in Waycross, GA

Active since July 29, 2006CLIA 11D2034603 · Waiver
1740 MEMORIAL DR, WAYCROSS, GA 31501(912) 338-9127 Get Directions Write a Review

NPPES record last updated: February 11, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 10, 2022, Dec 30, 2015 (2 updates tracked since 2015).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1154336279), doing business as Walgreens #09277, is a healthcare organization registered as a pharmacy in Waycross, Georgia and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through October 18, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1154336279
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address1740 MEMORIAL DRWaycross, GA 31501-1044
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateJuly 29, 2006
Last NPPES UpdateFebruary 11, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 11, 2026
NPI 1154336279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in GA · PHRE009009
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
1740 MEMORIAL DR, Waycross, GA 31501

Other Names 1

Doing Business AsWalgreens #09277

Other Identifiers 2

Medicaid000942741MGA
Other1153941Other Id Number-commercial Number

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 11D2034603

Walgreens #09277 · Waycross, GA
Active · expires Oct 18, 2027
CLIA Number11D2034603
Laboratory TypePharmacy
Certificate Effective DateOctober 19, 2025
Certificate Expiration DateOctober 18, 2027
Laboratory DirectorMichael C. Altman
Laboratory Phone(912) 338-9127
Laboratory LocationWalgreens #092771740 Memorial Drive, Waycross, GA 31501
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 3

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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.
51 services50 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.
27 services27 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.
22 services21 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #9277 carries, from the Medicare DMEPOS supplier directory.

Walgreens #9277

DMEPOS supplier · Waycross, GAOperated by Walgreen Co

Accepts Medicare assignment

Walgreens #9277 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)20354627
Medicare Participant SinceMarch 1, 2022
Supplier Location1740 Memorial DrWaycross, GA 31501
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 4

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

Pharmacist
1740 MEMORIAL DR
WAYCROSS, GA 31501
Pharmacist
1740 MEMORIAL DR
WAYCROSS, GA 31501
Pharmacist
1740 MEMORIAL DR
WAYCROSS, GA 31501
Pharmacist
1740 MEMORIAL DR
WAYCROSS, GA 31501

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154336279, enumerated as an "organization" on July 29, 2006.

The provider is located at 1740 MEMORIAL DR WAYCROSS, GA 31501 and the phone number is (912) 338-9127.

Pharmacy with taxonomy code 333600000X.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.