WALGREEN CO.
NPI 1255059507
Clinical Medical Laboratory in South Charleston, WV

Active since August 22, 2022CLIA 51D2233997 · Waiver
333 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25303(304) 744-8362 Get Directions Write a Review

NPPES record last updated: August 22, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Walgreen Co. NPPES

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

WALGREEN CO. (NPI 1255059507), doing business as Walgreens #17738, is a healthcare organization registered as a clinical medical laboratory in South Charleston, West Virginia and active in the NPI registry since August 2022. The organization holds a CLIA Waiver certificate valid through August 26, 2027 and lists Kira L Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1255059507
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameWALGREEN CO.
Location Address333 MACCORKLE AVE SWSouth Charleston, WV 25303-1263
Mailing Address1901 E Voorhees St # Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira L TaylorManager · (217) 709-2351
Enumeration DateAugust 22, 2022
NPPES CertifiedAugust 22, 2022
NPI 1255059507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition

(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

333 MACCORKLE AVE SW, South Charleston, WV 25303

Other Names 1

Doing Business AsWalgreens #17738

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 51D2233997

Walgreens #17738 · South Charleston, WV
Active · expires Aug 26, 2027
CLIA Number51D2233997
Laboratory TypePharmacy
Certificate Effective DateAugust 27, 2025
Certificate Expiration DateAugust 26, 2027
Laboratory DirectorTristan Maynard
Laboratory Phone(304) 744-8362
Laboratory LocationWalgreens #17738333 Maccorkle Avenue SW, South Charleston, WV 25303
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 · South Charleston, WV

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)20377769
Medicare Participant SinceMarch 1, 2022
Supplier Location333 Maccorkle Ave SWSouth Charleston, WV 25303
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 10

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

Pharmacist
333 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25303
Pharmacist
333 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25303
Pharmacist
333 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25303
Pharmacist
333 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25303
Pharmacist
333 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25303
Pharmacist
333 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25303
Pharmacist
333 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25303
Pharmacy
333 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25303

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 1255059507. It was assigned to this organization in the NPPES registry on August 22, 2022. The provider is doing business as Walgreens #17738.

Where is Walgreen Co. located?

Walgreen Co. is located at 333 Maccorkle Ave SW, South Charleston, WV 25303. The listed phone number is (304) 744-8362.

What is Walgreen Co.'s specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Walgreen Co. accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Walgreen Co accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Walgreen Co. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 51D2233997) is associated with this NPI, valid through August 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Walgreen Co. was last updated on August 22, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.