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RITE AID #19534
NPI 1235652264
Pharmacy in Shively, KY

Active since July 21, 2017CLIA Certified · 2 labs
4721 DIXIE HWY, SHIVELY, KY 40216(217) 709-2386 Get Directions Write a Review

NPPES record last updated: July 21, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Rite Aid #19534 NPPES

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

RITE AID #19534 (NPI 1235652264) is a healthcare organization registered as a pharmacy in Shively, Kentucky and active in the NPI registry since July 2017. The organization holds 2 active CLIA laboratory certificates and lists Alan Nielsen, Assistant Treasurer, as its authorized official.

NPPES Registry Identity

NPI1235652264
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address4721 DIXIE HWYShively, KY 40216-2654
Mailing Address1901 E Voorhees St # Ms 790Danville, IL 61834-4509 · (217) 709-2386 · Fax (217) 709-2344
Phone(217) 709-2386
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialAlan NielsenAssistant Treasurer · (847) 315-3523
Enumeration DateJuly 21, 2017
✔ NPI 1235652264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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 ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
4721 DIXIE HWY, Shively, KY 40216
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Other Names 1

Doing Business AsRite Aid #19534

CLIA Laboratory Certificates CMS CLIA 2

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 18D2011080

Walgreens #03756 · Louisville, KY
Active · expires May 25, 2027
CLIA Number18D2011080
Laboratory TypePharmacy
Certificate Effective DateMay 26, 2025
Certificate Expiration DateMay 25, 2027
Laboratory DirectorMs. Heidi C. Barrett
Laboratory Phone(502) 477-4232
Laboratory LocationWalgreens #037563980 Dixie Hwy, Louisville, KY 40216
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 18D2190550

Walgreens #11664 · Louisville, KY
Active · expires Aug 16, 2026
CLIA Number18D2190550
Laboratory TypeCovid-19 Test Site
Certificate Effective DateAugust 17, 2024
Certificate Expiration DateAugust 16, 2026
Laboratory DirectorMs. Thimira Sumanasekera
Laboratory Phone(502) 396-2296
Laboratory LocationWalgreens #116644926 Cane Run Road, Louisville, KY 40216
CLIA data matches this NPI record on: Name
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.

KWOK LEUNG BRYAN SUM PHARM D
Pharmacist
4721 DIXIE HWY
LOUISVILLE, KY 40216
Jefferson County (502) 447-9570
DR. CHRISTINA BEATRICE JOHNSON
Pharmacist
4721 DIXIE HWY
LOUISVILLE, KY 40216
Jefferson County (500) 244-7957
WALGREEN CO
Pharmacy
4721 DIXIE HWY
SHIVELY, KY 40216
Jefferson County (217) 709-2386
OLUGBENGA AKINDELE B. PHARM.
Pharmacist
4721 DIXIE HWY
LOUISVILLE, KY 40216
Jefferson County (503) 447-6550
JOHN W KNOOP RPH
Pharmacist
4721 DIXIE HWY
SHIVELY, KY 40216
Jefferson County (502) 447-6550

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 1235652264. It was assigned to this organization in the NPPES registry on July 21, 2017. The provider is doing business as Rite Aid #19534.

Where is Walgreen Co located?

Walgreen Co is located at 4721 Dixie Hwy, Shively, KY 40216. The listed phone number is (217) 709-2386.

What is Walgreen Co's specialty?

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

Does Walgreen Co hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Walgreen Co was last updated on July 21, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.