WALGREENS #09965
NPI 1306949433
Pharmacy in Rantoul, IL

Q: What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1306949433. It was assigned to this organization in the NPPES registry on September 6, 2006. The provider is doing business as Walgreens #09965.

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 September 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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 September 06, 2006CLIA 14D2037867 · Waiver

220 S CENTURY BLVD, RANTOUL, IL 61866(217) 892-8415(217) 892-8702 Get Directions Write a Review

NPPES record last updated: September 30, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 30, 2024, Nov 3, 2023, Feb 28, 2022 and 2 more (5 updates tracked since 2015).

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About Walgreens #09965 NPPES

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

WALGREENS #09965 (NPI 1306949433) is a healthcare organization registered as a pharmacy in Rantoul, Illinois and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through March 23, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1306949433

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address220 S CENTURY BLVDRantoul, IL 61866-2309

Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (847) 527-2489 · Fax (217) 709-2344

Phone(217) 892-8415

Fax(217) 892-8702

Organization SubpartYesParent: Walgreens Boots Alliance Inc

Authorized OfficialJennifer PonceManager · (847) 527-2489

Enumeration DateSeptember 6, 2006

Last NPPES UpdateSeptember 30, 20245 updates tracked since enumeration

NPPES CertifiedSeptember 30, 2024

✔ NPI 1306949433 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in IL · 054.019020

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

220 S CENTURY BLVD, Rantoul, IL 61866

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Other Names 1

Doing Business AsWalgreens #09965

Other Identifiers 1

Other1479864Ncpdp

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 14D2037867

Walgreens #09965 · Rantoul, IL

Active · expires Mar 23, 2027

CLIA Number14D2037867

Laboratory TypePharmacy

Certificate Effective DateMarch 24, 2025

Certificate Expiration DateMarch 23, 2027

Laboratory DirectorKathleen M. Rouse

Laboratory Phone(217) 892-8415

Laboratory LocationWalgreens #09965220 S Century Blvd, Rantoul, IL 61866

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 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.

135 services135 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.

95 services95 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.

29 services29 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.

29 services29 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.

25 services25 patients

Other Providers at the Same Location NPPES 7

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

ALEXA CROSSMAN

Pharmacist