WALGREEN CO
NPI 1164676995
Pharmacy in Vail, AZ

Active since November 06, 2008CLIA 03D2064153 · Waiver
13542 E COLOSSAL CAVE RD, VAIL, AZ 85641(520) 232-2763(520) 232-2769 Get Directions Write a Review

NPPES record last updated: August 1, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 24, 2023, Mar 10, 2022 (2 updates tracked since 2022).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1164676995), doing business as Walgreens #10684, is a healthcare organization registered as a pharmacy in Vail, Arizona and active in the NPI registry since November 2008. The organization holds a CLIA Waiver certificate valid through March 18, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1164676995
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address13542 E COLOSSAL CAVE RDVail, AZ 85641-8849
Mailing Address1901 E Voorhees St # 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Fax(520) 232-2769
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateNovember 6, 2008
Last NPPES UpdateAugust 1, 20252 updates tracked since enumeration
NPPES CertifiedAugust 1, 2025
NPI 1164676995 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in AZ · Y005065
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
13542 E COLOSSAL CAVE RD, Vail, AZ 85641

Other Names 1

Doing Business AsWalgreens #10684

Other Identifiers 2

Other0355669Ncpdp
Medicaid406193AZ

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 03D2064153

Walgreens #10684 · Vail, AZ
Active · expires Mar 18, 2027
CLIA Number03D2064153
Laboratory TypePharmacy
Certificate Effective DateMarch 19, 2025
Certificate Expiration DateMarch 18, 2027
Laboratory DirectorJanice A. Woods
Laboratory Phone(520) 232-2763
Laboratory LocationWalgreens #1068413542 E Colossal Cave Rd, Vail, AZ 85641
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 5

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.
163 services158 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.
99 services98 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.
52 services52 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
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.
13 services13 patients
Administration of pneumococcal vaccine G0009
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.
13 services13 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20387123
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

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
13542 E COLOSSAL CAVE RD
VAIL, AZ 85641
Pharmacist
13542 E COLOSSAL CAVE RD
VAIL, AZ 85641
Pharmacist
13542 E COLOSSAL CAVE RD
VAIL, AZ 85641
Pharmacist
13542 E COLOSSAL CAVE RD
VAIL, AZ 85641
Pharmacist
13542 E COLOSSAL CAVE RD
VAIL, AZ 85641

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164676995, enumerated as an "organization" on November 06, 2008.

The provider is located at 13542 E COLOSSAL CAVE RD VAIL, AZ 85641 and the phone number is (520) 232-2763.

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.