1. Home
  2. Directory
  3. Maryland
  4. Riverdale
  5. Pharmacy
  6. NPI Profile

WALGREEN CO
NPI 1225553704
Pharmacy in Riverdale, MD

Active since August 07, 2017CLIA 21D2293323 · Waiver
6130 BALTIMORE AVE, RIVERDALE, MD 20737(301) 699-5004(301) 699-0178 Get Directions Write a Review

NPPES record last updated: February 12, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 12, 2025, Jun 7, 2022, Feb 11, 2020 and 4 more (7 updates tracked since 2017).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1225553704), doing business as Walgreens #19312, is a healthcare organization registered as a pharmacy in Riverdale, Maryland and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through November 6, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1225553704
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address6130 BALTIMORE AVERiverdale, MD 20737-1905
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (847) 527-2489 · Fax (217) 709-2344
Phone(301) 699-5004
Fax(301) 699-0178
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateAugust 7, 2017
Last NPPES UpdateFebruary 12, 20257 updates tracked since enumeration
NPPES CertifiedFebruary 12, 2025
✔ NPI 1225553704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in MD · P07767
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
6130 BALTIMORE AVE, Riverdale, MD 20737
Open in Google Maps ↗

Other Names 1

Doing Business AsWalgreens #19312

Other Identifiers 2

Medicaid747781300MD
Other2141606MD · Ncpdp

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 21D2293323

Walgreens #19312 · Riverdale, MD
Active · expires Nov 6, 2027
CLIA Number21D2293323
Laboratory TypePharmacy
Certificate Effective DateNovember 7, 2025
Certificate Expiration DateNovember 6, 2027
Laboratory DirectorIssa Abdurahman
Laboratory Phone(301) 699-5004
Laboratory LocationWalgreens #193126130 Baltimore Ave, Riverdale, MD 20737
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 5

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

ROBERT KABUTEY
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
6130 BALTIMORE AVE
RIVERDALE, MD 20737
Prince George's County (301) 699-5004
SEULBI LEE
Pharmacist
6130 BALTIMORE AVE
RIVERDALE, MD 20737
Prince George's County (301) 699-5004
WALGREEN CO.
Pharmacy
6130 BALTIMORE AVE
RIVERDALE, MD 20737
Prince George's County (301) 699-5004
RITE AID PHARMACY
Long Term Care Hospital
6130 BALTIMORE AVE
RIVERDALE, MD 20737
Prince George's County (301) 699-5004
FIKIRTA FORRESTER NP
Nurse Practitioner (Family)
6130 BALTIMORE AVE
RIVERDALE PARK, MD 20737
Prince George's County (301) 699-5004

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 1225553704. It was assigned to this organization in the NPPES registry on August 7, 2017. The provider is doing business as Walgreens #19312.

Where is Walgreen Co located?

Walgreen Co is located at 6130 Baltimore Ave, Riverdale, MD 20737. The listed phone number is (301) 699-5004.

What is Walgreen Co's specialty?

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

Does Walgreen Co hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2293323) is associated with this NPI, valid through November 6, 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 39 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 February 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.