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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

WALGREEN CO
NPI 1174534309
Pharmacy in Utuado, PR

Active since August 11, 2006CLIA 40D2233394 · Waiver
940 CARR 123, UTUADO, PR 00641(787) 894-0574(787) 894-9515 Get Directions Write a Review

NPPES record last updated: October 26, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 26, 2026, Oct 14, 2026, Nov 2, 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 1174534309), doing business as Walgreens #00185, is a healthcare organization registered as a pharmacy in Utuado, Puerto Rico and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through August 22, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1174534309
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address940 CARR 123Utuado, PR 00641-3201
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Phone(787) 894-0574
Fax(787) 894-9515
Organization SubpartYesParent: Walgreens Holding Company
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateAugust 11, 2006
Last NPPES UpdateOctober 26, 20264 updates tracked since enumeration
NPPES CertifiedOctober 26, 2026
✔ NPI 1174534309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in PR · 07F1450
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

Other Names 1

Doing Business AsWalgreens #00185

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Walgreen Co is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StatePuerto RicoEnrollment IDO20100930076169DME · PharmacyDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

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 40D2233394

Walgreens # 00185 · Utuado, PR
Active · expires Aug 22, 2027
CLIA Number40D2233394
Laboratory TypePharmacy
Certificate Effective DateAugust 23, 2025
Certificate Expiration DateAugust 22, 2027
Laboratory DirectorCelines Rodriguez
Laboratory Phone(787) 894-0574
Laboratory LocationWalgreens # 00185940 Carr 123, Utuado, PR 00641
CLIA data matches this NPI record on: Address Name Phone
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.

MRS. MORAIMA MORAN
Pharmacist
940 CARR 123
UTUADO, PR 00641
Utuado Municipio (787) 894-0574
BRENDA IVELISSE AVILES
Pharmacist
940 CARR 123
UTUADO, PR 00641
Utuado Municipio (787) 894-0100

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 1174534309. It was assigned to this organization in the NPPES registry on August 11, 2006. The provider is doing business as Walgreens #00185.

Where is Walgreen Co located?

Walgreen Co is located at 940 Carr 123, Utuado, PR 00641. The listed phone number is (787) 894-0574.

What is Walgreen Co's specialty?

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

Is Walgreen Co enrolled in Medicare?

Yes. Walgreen Co is registered in the Medicare PECOS enrollment system.

When is Walgreen Co's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Puerto Rico, Pharmacy) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Walgreen Co hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 40D2233394) is associated with this NPI, valid through August 22, 2027. 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 36 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 October 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days 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.