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WALGREENS #12153
NPI 1164670055
Pharmacy in Kansas City, MO

Active since September 04, 2008CLIA 26D2311587 · Waiver
358 E US HIGHWAY 69, KANSAS CITY, MO 64119(816) 413-0079(816) 413-0687 Get Directions Write a Review

NPPES record last updated: March 29, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Apr 5, 2019, Jun 15, 2018, May 14, 2018 and 1 more (4 updates tracked since 2016).

About Walgreens #12153 NPPES

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

WALGREENS #12153 (NPI 1164670055) is a healthcare organization registered as a pharmacy in Kansas City, Missouri and active in the NPI registry since September 2008. The organization holds a CLIA Waiver certificate valid through September 23, 2028 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1164670055
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address358 E US HIGHWAY 69Kansas City, MO 64119-3117
Mailing Address1901 E Voorhees St, Ms #790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Phone(816) 413-0079
Fax(816) 413-0687
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateSeptember 4, 2008
Last NPPES UpdateMarch 29, 20224 updates tracked since enumeration
NPPES CertifiedMarch 29, 2022
✔ NPI 1164670055 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
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 · License 2009000489 (MO)
358 E US HIGHWAY 69, Kansas City, MO 64119
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Other Names 1

Doing Business AsWalgreens #12153

Other Identifiers 2

Other2638192MO · Ncpdp
Medicaid606394809MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Moda Health Plan, Inc..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 26D2311587

Walgreens Health Services, LLC · Kansas City, MO
Active · expires Sep 23, 2028
CLIA Number26D2311587
Laboratory TypeHealth Clinic
Certificate Effective DateSeptember 24, 2026
Certificate Expiration DateSeptember 23, 2028
Laboratory DirectorSashidaran M. Moodley
Laboratory Phone(847) 315-2500
Laboratory LocationWalgreens Health Services, LLC2630 NE Vivion Rd Suite 101, Kansas City, MO 64119
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

DR. SARAH ELIZABETH NOBLE PHARMD
Pharmacist
358 E US HIGHWAY 69
CLAYCOMO, MO 64119
Clay County (816) 413-0079
DR. AUSTIN JOSEPH BIELBY PHARM D.
Pharmacist
358 E US HIGHWAY 69
KANSAS CITY, MO 64119
Clay County (816) 413-0079

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 1164670055. It was assigned to this organization in the NPPES registry on September 4, 2008. The provider is doing business as Walgreens #12153.

Where is Walgreen Co located?

Walgreen Co is located at 358 E Us Highway 69, Kansas City, MO 64119. The listed phone number is (816) 413-0079.

What is Walgreen Co's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Walgreen Co hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2311587) is associated with this NPI, valid through September 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Walgreen Co accept?

Health plans from Medica and Moda Health Plan, Inc. list Walgreen Co as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Walgreen Co was last updated on March 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.