WALGREENS #04876
NPI 1255346243
Pharmacy in Edison, NJ

Q: What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1255346243. It was assigned to this organization in the NPPES registry on July 29, 2006. The provider is doing business as Walgreens #04876.

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 April 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 July 29, 2006CLIA Certified · 2 labs

905 NEW DURHAM RD, EDISON, NJ 08817(732) 287-3652(732) 287-3877 Get Directions Write a Review

NPPES record last updated: April 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 21, 2022, Dec 6, 2019, Jul 18, 2019 and 2 more (5 updates tracked since 2015).

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About Walgreens #04876 NPPES

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

WALGREENS #04876 (NPI 1255346243) is a healthcare organization registered as a pharmacy in Edison, New Jersey and active in the NPI registry since July 2006. The organization holds 2 active CLIA laboratory certificates and lists Kira L Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1255346243

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address905 NEW DURHAM RDEdison, NJ 08817

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

Phone(732) 287-3652

Fax(732) 287-3877

Organization SubpartYesParent: Walgreens Boots Alliance Inc

Authorized OfficialKira L TaylorManager · (217) 709-2351

Enumeration DateJuly 29, 2006

Last NPPES UpdateApril 21, 20225 updates tracked since enumeration

NPPES CertifiedApril 21, 2022

✔ NPI 1255346243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in NJ · RS005759

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

905 NEW DURHAM RD, Edison, NJ 08817

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Other Names 1

Doing Business AsWalgreens #04876

Other Identifiers 2

Medicaid8035202NJ

Other3141253NJ · 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 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 31D2035874

Walgreens#04876 · Edison, NJ

Active · expires Feb 17, 2027

CLIA Number31D2035874

Laboratory TypePharmacy

Certificate Effective DateFebruary 18, 2025

Certificate Expiration DateFebruary 17, 2027

Laboratory DirectorFalguni R. Patel

Laboratory Phone(732) 287-3652

Laboratory LocationWalgreens#04876905 New Durham Road, Edison, NJ 08817

CLIA data matches this NPI record on: Address Name Phone

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

Certificate of Waiver 31D2205295

Walgreens # 09932 · Edison, NJ

Active · expires Dec 13, 2026

CLIA Number31D2205295

Laboratory TypeCovid 19 Test Site

Certificate Effective DateDecember 14, 2024

Certificate Expiration DateDecember 13, 2026

Laboratory DirectorNancy Tonzola

Laboratory Phone(732) 572-2925

Laboratory LocationWalgreens # 0993281 Plainfield Avenue, Edison, NJ 08817

CLIA data matches this NPI record on: Name

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

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

191 services190 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

126 services126 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

47 services47 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

34 services34 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

32 services32 patients

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Other Providers at the Same Location NPPES 8

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

AYAH I KHATTAB

Pharmacist