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WALGREENS #17490
NPI 1184140816
Pharmacy in Passaic, NJ

Active since August 15, 2017
78 MAIN AVE, PASSAIC, NJ 07055(973) 778-0510(973) 778-4985 Get Directions Write a Review

NPPES record last updated: June 27, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 15, 2018, May 10, 2018, May 2, 2018 and 2 more (5 updates tracked since 2017).

About Walgreens #17490 NPPES

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

WALGREENS #17490 (NPI 1184140816) is a healthcare organization registered as a pharmacy in Passaic, New Jersey and active in the NPI registry since August 2017. The organization lists Alyssa Sweeten, Manager, as its authorized official.

NPPES Registry Identity

NPI1184140816
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address78 MAIN AVEPassaic, NJ 07055-4466
Mailing Address1901 E Voorhees St # Ms 790Danville, IL 61834-4509 · (217) 709-2386 · Fax (217) 709-2344
Phone(973) 778-0510
Fax(973) 778-4985
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialAlyssa SweetenManager · (217) 709-2386
Enumeration DateAugust 15, 2017
Last NPPES UpdateJune 27, 20195 updates tracked since enumeration
✔ NPI 1184140816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in NJ · 28RS00331200
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
78 MAIN AVE, Passaic, NJ 07055
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Other Names 1

Doing Business AsWalgreens #17490

Other Identifiers 2

Medicaid0611565NJ
Other3153462NJ · Ncpdp

Accepted Insurance

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

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #13706 carries, from the Medicare DMEPOS supplier directory.

Walgreens #13706

DMEPOS supplier · Warren, NJOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #13706 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)20386187
Medicare Participant SinceMarch 1, 2022
Supplier Location110 Moutain BlvdWarren, NJ 07059
Phone(732) 907-6745
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 3

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

RANIA H SEDRAK
Pharmacist
78 MAIN AVE
PASSAIC, NJ 07055
Passaic County (973) 778-0510
LOVENESS JACOB KAALE-SENELORM PHARM.D
Pharmacist
78 MAIN AVE
PASSAIC, NJ 07055
Passaic County (973) 778-0971
RICHARD AMERICO LAMBROSCHINO RPH
Pharmacist
78 MAIN AVE
PASSAIC, NJ 07055
Passaic County (973) 778-0510

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 1184140816. It was assigned to this organization in the NPPES registry on August 15, 2017. The provider is doing business as Walgreens #17490.

Where is Walgreen Co located?

Walgreen Co is located at 78 Main Ave, Passaic, NJ 07055. The listed phone number is (973) 778-0510.

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, Walgreens #13706 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

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 June 27, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.