Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

WALGREEN CO
NPI 1255346581
Pharmacy in Fremont, CA

Active since July 29, 2006CLIA 05D2254261 · Waiver
2600 MOWRY AVE, FREMONT, CA 94538(510) 742-9356 Get Directions Write a Review

NPPES record last updated: June 8, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 13, 2026, Apr 5, 2022, Sep 28, 2018 (3 updates tracked since 2018).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1255346581), doing business as Walgreens #04517, is a healthcare organization registered as a pharmacy in Fremont, California and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through March 1, 2028 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1255346581
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address2600 MOWRY AVEFremont, CA 94538-1619
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Organization SubpartYesParent: Walgreens Holding Company
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateJuly 29, 2006
Last NPPES UpdateJune 8, 20263 updates tracked since enumeration
NPPES CertifiedJune 8, 2026
NPI 1255346581 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in CA · PHY45894
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
2600 MOWRY AVE, Fremont, CA 94538

Other Names 1

Doing Business AsWalgreens #04517

Other Identifiers 2

Other0581567Other Id Number-commercial Number
Medicaid1255346581CA

Accepted 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 05D2254261

Walgreens #04517 · Fremont, CA
Active · expires Mar 1, 2028
CLIA Number05D2254261
Laboratory TypeClinic
Certificate Effective DateMarch 2, 2026
Certificate Expiration DateMarch 1, 2028
Laboratory DirectorSashidaran Moodley
Laboratory Phone(510) 742-9356
Laboratory LocationWalgreens #045172600 Mowry Avenue, Fremont, CA 94538
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

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.
107 services107 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.
56 services56 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.
37 services37 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #04517 carries, from the Medicare DMEPOS supplier directory.

Walgreens #04517

DMEPOS supplier · Fremont, CAOperated by Walgreen Co

Accepts Medicare assignment

Walgreens #04517 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)20363957
Medicare Participant SinceMarch 1, 2022
Supplier Location2600 Mowry AveFremont, CA 94538
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 9

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

Pharmacist
2600 MOWRY AVE
FREMONT, CA 94538
Pharmacist
2600 MOWRY AVE
FREMONT, CA 94538
Pharmacy (Community/Retail Pharmacy)
2600 MOWRY AVE
FREMONT, CA 94538
Pharmacist
2600 MOWRY AVE
FREMONT, CA 94538
Pharmacy (Community/Retail Pharmacy)
2600 MOWRY AVE
FREMONT, CA 94538
Licensed Vocational Nurse
2600 MOWRY AVE
FREMONT, CA 94538
Pharmacist
2600 MOWRY AVE
FREMONT, CA 94538
Pharmacist
2600 MOWRY AVE
FREMONT, CA 94538

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 1255346581. It was assigned to this organization in the NPPES registry on July 29, 2006. The provider is doing business as Walgreens #04517.

Where is Walgreen Co located?

Walgreen Co is located at 2600 Mowry Ave, Fremont, CA 94538. The listed phone number is (510) 742-9356.

What is Walgreen Co's specialty?

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

Does Walgreen Co accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Walgreens #04517 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 05D2254261) is associated with this NPI, valid through March 1, 2028. 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 June 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 59 days 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.