WALGREENS #05247
NPI 1174530182
Pharmacy in Independence, MO

Active since August 02, 2006CLIA 26D2012526 · Waiver
3915 S NOLAND RD, INDEPENDENCE, MO 64055(816) 254-8748 Get Directions Write a Review

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

Record update history: Apr 25, 2022, May 11, 2018, Apr 20, 2017 and 1 more (4 updates tracked since 2015).

About Walgreens #05247 NPPES

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

WALGREENS #05247 (NPI 1174530182) is a healthcare organization registered as a pharmacy in Independence, Missouri and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through December 20, 2026 and lists Kira L Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1174530182
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address3915 S NOLAND RDIndependence, MO 64055-3346
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira L TaylorManager · (217) 709-2351
Enumeration DateAugust 2, 2006
Last NPPES UpdateApril 25, 20224 updates tracked since enumeration
NPPES CertifiedApril 25, 2022
NPI 1174530182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in MO · 2000151092
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
3915 S NOLAND RD, Independence, MO 64055

Other Names 1

Doing Business AsWalgreens #05247

Other Identifiers 5

Medicaid100432520AKS
Medicaid604857003MO
Medicaid624857009 DMEMO
Medicaid100432520B DMEKS
Other2632974Other 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 26D2012526

Walgreen #05247 · Independence, MO
Active · expires Dec 20, 2026
CLIA Number26D2012526
Laboratory TypeCovid-19 Testing Site
Certificate Effective DateDecember 21, 2024
Certificate Expiration DateDecember 20, 2026
Laboratory DirectorAmanda Tenholder
Laboratory Phone(816) 254-8748
Laboratory LocationWalgreen #052473915 S Noland Rd, Independence, MO 64055
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 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.
101 services101 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.
59 services59 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.
36 services36 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreen Co carries, from the Medicare DMEPOS supplier directory.

Walgreen Co

DMEPOS supplier · Independence, MO

Accepts Medicare assignment

Walgreen Co 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)20391245
Medicare Participant SinceMarch 1, 2022
Supplier Location3915 S Noland RdIndependence, MO 64055
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 11

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

Pharmacist
3915 S NOLAND RD
INDEPENDENCE, MO 64055
Nurse Practitioner (Family)
3915 S NOLAND RD
INDEPENDENCE, MO 64055
Pharmacist
3915 S NOLAND RD
INDEPENDENCE, MO 64055
Pharmacist
3915 S NOLAND RD
INDEPENDENCE, MO 64055
Pharmacist
3915 S NOLAND RD
INDEPENDENCE, MO 64055
Pharmacist
3915 S NOLAND RD
INDEPENDENCE, MO 64055
Pharmacist
3915 S NOLAND RD
INDEPENDENCE, MO 64055
Pharmacist
3915 S NOLAND RD
INDEPENDENCE, MO 64055

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 1174530182. It was assigned to this organization in the NPPES registry on August 2, 2006. The provider is doing business as Walgreens #05247.

Where is Walgreen Co located?

Walgreen Co is located at 3915 S Noland Rd, Independence, MO 64055. The listed phone number is (816) 254-8748.

What is Walgreen Co's specialty?

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

Does Walgreen Co accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Walgreen Co 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 26D2012526) is associated with this NPI, valid through December 20, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Walgreen Co accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 42 other insurers 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 April 25, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.