WALGREEN CO
NPI 1154337731
Pharmacy in Saint Clair Shores, MI

Active since August 01, 2006CLIA 23D2059911 · Waiver
21211 HARPER AVE, SAINT CLAIR SHORES, MI 48080(586) 776-7052 Get Directions Write a Review

NPPES record last updated: June 3, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 3, 2026, Jan 24, 2026, Nov 8, 2023 and 1 more (4 updates tracked since 2022).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1154337731), doing business as Walgreens #01610, is a healthcare organization registered as a pharmacy in Saint Clair Shores, Michigan and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through August 14, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1154337731
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address21211 HARPER AVESaint Clair Shores, MI 48080-2208
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Organization SubpartYesParent: Walgreens Holding Company
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateAugust 1, 2006
Last NPPES UpdateJune 3, 20264 updates tracked since enumeration
NPPES CertifiedJune 3, 2026
NPI 1154337731 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in MI · 5301008180
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
21211 HARPER AVE, Saint Clair Shores, MI 48080

Other Names 1

Doing Business AsWalgreens #01610

Other Identifiers 3

Medicaid4810081 DMEMI
Other2367503Other Id Number-commercial Number
Medicaid2367503MI

Accepted Insurance

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of influenza virus vaccine

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.

This service was performed 168 times for 167 patients

Administration of pneumococcal vaccine

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.

This service was performed 15 times for 15 patients

Influenza vaccine split virus, preservative free

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.

This service was performed 98 times for 98 patients

Influenza vaccine, inactivated

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.

This service was performed 60 times for 60 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use

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.

This service was performed 15 times for 15 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20353991
Accepts Medicare Assignment
YES
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • 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
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
23D2059911
Facility Type
Pharmacy
Certificate Effective Date
August 15, 2025
Certificate Expiration Date
August 14, 2027
Laboratory Director
KIMBERLY L. DAINTY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Walgreen Co to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for WALGREEN CO

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Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Pharmacist
21211 HARPER AVE
ST CLAIR SHORES, MI 48080
Pharmacist
21211 HARPER AVE
SAINT CLAIR SHORES, MI 48080
Pharmacist
21211 HARPER AVE
SAINT CLAIR SHORES, MI 48080
Pharmacist
21211 HARPER AVE
SAINT CLAIR SHORES, MI 48080

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154337731, enumerated as an "organization" on August 01, 2006.

The provider is located at 21211 HARPER AVE SAINT CLAIR SHORES, MI 48080 and the phone number is (586) 776-7052.

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.