WALGREEN CO
NPI 1346494176
Pharmacy in Maryville, IL

Active since November 06, 2008CLIA 14D2019076 · Waiver
6607 STATE ROUTE 162, MARYVILLE, IL 62062(618) 288-2130(618) 288-2136 Get Directions Write a Review

NPPES record last updated: February 11, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1346494176), doing business as Walgreens #12395, is a healthcare organization registered as a pharmacy in Maryville, Illinois and active in the NPI registry since November 2008. The organization holds a CLIA Waiver certificate valid through March 4, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1346494176
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address6607 STATE ROUTE 162Maryville, IL 62062-8514
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Fax(618) 288-2136
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateNovember 6, 2008
Last NPPES UpdateFebruary 11, 2026
NPPES CertifiedFebruary 11, 2026
NPI 1346494176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in IL · 054.019174
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
6607 STATE ROUTE 162, Maryville, IL 62062

Other Names 1

Doing Business AsWalgreens #12395

Other Identifiers 1

Other1482645Ncpdp

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 14D2019076

Walgreens # 12395 · Maryville, IL
Active · expires Mar 4, 2027
CLIA Number14D2019076
Laboratory TypePharmacy
Certificate Effective DateMarch 5, 2025
Certificate Expiration DateMarch 4, 2027
Laboratory DirectorKyle Jones
Laboratory Phone(618) 288-2130
Laboratory LocationWalgreens # 123956607 State Route 162, Maryville, IL 62062
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.
287 services287 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.
199 services199 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.
66 services66 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.
23 services23 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.
20 services20 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #12395 carries, from the Medicare DMEPOS supplier directory.

Walgreens #12395

DMEPOS supplier · Maryville, ILOperated by Walgreen Co

Accepts Medicare assignment

Walgreens #12395 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)20387015
Medicare Participant SinceMarch 1, 2022
Supplier Location6607 State Route 162Maryville, IL 62062
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
6607 STATE ROUTE 162
MARYVILLE, IL 62062
Clinical Medical Laboratory
6607 STATE ROUTE 162
MARYVILLE, IL 62062
Pharmacist
6607 STATE ROUTE 162
MARYVILLE, IL 62062
Pharmacist
6607 STATE ROUTE 162
MARYVILLE, IL 62062
Pharmacist
6607 STATE ROUTE 162
MARYVILLE, IL 62062
Pharmacist
6607 STATE ROUTE 162
MARYVILLE, IL 62062
Pharmacist
6607 STATE ROUTE 162
MARYVILLE, IL 62062
Pharmacist
6607 STATE ROUTE 162
MARYVILLE, IL 62062

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 1346494176. It was assigned to this organization in the NPPES registry on November 6, 2008. The provider is doing business as Walgreens #12395.

Where is Walgreen Co located?

Walgreen Co is located at 6607 State Route 162, Maryville, IL 62062. The listed phone number is (618) 288-2130.

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 #12395 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 14D2019076) is associated with this NPI, valid through March 4, 2027. 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 40 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 February 11, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.