WALGREENS #16030
NPI 1215336359
Pharmacy in Portland, TX

Q: What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1215336359. It was assigned to this organization in the NPPES registry on August 14, 2014. The provider is doing business as Walgreens #16030.

Q: What is Walgreen Co's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Walgreen Co was last updated on February 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since August 14, 2014CLIA 45D2084768 · Waiver

1105 US HIGHWAY 181, PORTLAND, TX 78374(361) 229-7251(361) 229-7252 Get Directions Write a Review

NPPES record last updated: February 23, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 23, 2023, May 4, 2022, Jan 17, 2017 and 1 more (4 updates tracked since 2016).

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About Walgreens #16030 NPPES

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

WALGREENS #16030 (NPI 1215336359) is a healthcare organization registered as a pharmacy in Portland, Texas and active in the NPI registry since August 2014. The organization holds a CLIA Waiver certificate valid through August 30, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1215336359

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address1105 US HIGHWAY 181Portland, TX 78374-1700

Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344

Phone(361) 229-7251

Fax(361) 229-7252

Organization SubpartYesParent: Walgreens Boots Alliance

Authorized OfficialKira TaylorManager · (217) 709-2351

Enumeration DateAugust 14, 2014

Last NPPES UpdateFebruary 23, 20234 updates tracked since enumeration

NPPES CertifiedFebruary 23, 2023

✔ NPI 1215336359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ 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 ListedClinical Medical LaboratoryTaxonomy 291U00000X

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X

1105 US HIGHWAY 181, Portland, TX 78374

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Other Names 1

Doing Business AsWalgreens #16030

Other Identifiers 2

Other5912541TX · Ncpdp

Medicaid468829TX

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 ›

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 45D2084768

Walgreens #16030 · Portland, TX

Active · expires Aug 30, 2027

CLIA Number45D2084768

Laboratory TypePharmacy

Certificate Effective DateAugust 31, 2025

Certificate Expiration DateAugust 30, 2027

Laboratory DirectorKelvin Park

Laboratory Phone(361) 229-7251

Laboratory LocationWalgreens #160301105 Us Hwy 181, Portland, TX 78374

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 · Portland, TX

✔

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)20387723

Medicare Participant SinceMarch 1, 2022

Supplier Location1105 Us Highway 181Portland, TX 78374

Phone(361) 229-7251

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 6

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

DR. DAI LE PHARMD

Pharmacist