WALGREEN CO - NPI 1255660346 - Pharmacy in Jefferson City, MO

Q: What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1255660346. It was assigned to this organization in the NPPES registry on December 18, 2009. The provider is doing business as Walgreens #12749.

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 February 10, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Walgreen Co NPPES

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

WALGREEN CO (NPI 1255660346), doing business as Walgreens #12749, is a healthcare organization registered as a pharmacy in Jefferson City, Missouri and active in the NPI registry since December 2009. The organization holds a CLIA Waiver certificate valid through April 25, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1255660346

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address900 EASTLAND DRJefferson City, MO 65101-3894

Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344

Phone(573) 556-5615

Fax(573) 556-8749

Organization SubpartYesParent: Walgreens Boots Alliance Inc

Authorized OfficialJennifer PonceManager · (847) 527-2489

Enumeration DateDecember 18, 2009

Last NPPES UpdateFebruary 10, 20266 updates tracked since enumeration

NPPES CertifiedFebruary 10, 2026

✔ NPI 1255660346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in MO · 2010007861

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 · Clinic PharmacyTaxonomy 3336C0002X

900 EASTLAND DR, Jefferson City, MO 65101

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Other Names 1

Doing Business AsWalgreens #12749

Other Identifiers 3

Medicaid1255660346IA

Medicaid606469500MO

Other2638952MO · 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 26D2046415

Walgreens #12749 · Jefferson City, MO

Active · expires Apr 25, 2027

CLIA Number26D2046415

Laboratory TypePharmacy

Certificate Effective DateApril 26, 2025

Certificate Expiration DateApril 25, 2027

Laboratory DirectorSophie Branson

Laboratory Phone(573) 556-5615

Laboratory LocationWalgreens #12749900 Eastland Dr, Jefferson City, MO 65101

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.

116 services116 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.

72 services72 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

Other Providers at the Same Location NPPES 6

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

LISA LUMPKIN PHARMD

Pharmacist