WALGREENS #21409
NPI 1356004865
Pharmacy in Corvallis, OR
NPI Status: Active since October 21, 2021
Contact Information
1555 SW 53RD ST
CORVALLIS, OR
ZIP 97333
Phone: (541) 758-3392
Fax: (866) 260-2487
- Organization
- Pharmacy
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 38D2298071
- CLIA Cert. Type: Pharmacy
- CLIA Exp. Date: 01-25-2026
About WALGREENS #21409
This page provides the complete NPI Profile along with additional information for Walgreens #21409, a provider established in Corvallis, Oregon operating as a Pharmacy. The healthcare provider is registered in the NPI registry with number 1356004865 assigned on October 2021. The practitioner's primary taxonomy code is 333600000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Walgreens #21409. The authorized official of this NPI record is Kira Taylor (Manager)
- NPI
- 1356004865
- Provider Legal Name
- WALGREEN CO
- Other Organization Name
- WALGREENS #21409
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1555 SW 53RD ST CORVALLIS, OR 97333
- Location Phone
- (541) 758-3392
- Location Fax
- (866) 260-2487
- Mailing Address
- 1901 E VOORHEES ST MS 790 DANVILLE, IL 61834
- Mailing Phone
- (217) 709-2351
- Mailing Fax
- (866) 260-2487
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 10-21-2021
- Last Update Date
- 06-15-2022
- Code Navigator
Walgreens #21409 is a medicare supplier with PTAN 20382563 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Blood Glucose Monitors/Supplies (Non-Mail Order).
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy
- Taxonomy Code
- 333600000X
- Type
- Suppliers
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
| 2 | 3336C0003X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Balance by Medica Bronze $0 Copay PCP Visits - EPO
- Balance by Medica Bronze $0 Copay PCP Visits - PPO
- Balance by Medica Bronze Premier - EPO
- Balance by Medica Bronze Premier - PPO
- Balance by Medica Expanded Bronze Standard - EPO
- Balance by Medica Expanded Bronze Standard - PPO
- Balance by Medica Gold $0 Copay PCP Visits - EPO
- Balance by Medica Gold $0 Copay PCP Visits - PPO
- Balance by Medica Gold Share - EPO
- Balance by Medica Gold Share - PPO
- Balance by Medica Gold Standard - EPO
- Balance by Medica Gold Standard - PPO
- Balance by Medica Silver $0 Copay PCP Visits - EPO
- Balance by Medica Silver $0 Copay PCP Visits - PPO
- Balance by Medica Silver Share - EPO
- Balance by Medica Silver Share - PPO
- Balance by Medica Silver Standard - EPO
- Balance by Medica Silver Standard - PPO
- Harmony by Medica Bronze $0 Copay PCP Visits - PPO
- Harmony by Medica Bronze $0 Copay PCP Visits + Adult Eye Exam - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20382563
- Accepts Medicare Assignment
- YES
- Specialities List
- Pharmacy.
- Competitive Bidding
- NO
Supplies List
- 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
- 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
- Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 38D2298071
- Facility Type
- Pharmacy
- Certificate Effective Date
- January 26, 2024
- Certificate Expiration Date
- January 25, 2026
- Laboratory Director
- MICHAEL W. WILL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Walgreens #21409 to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1356004865, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1356004865, enumerated as an "organization" on October 21, 2021.
The provider is located at 1555 SW 53RD ST CORVALLIS, OR 97333 and the phone number is (541) 758-3392.
Pharmacy with taxonomy code 333600000X.
The provider might be accepting Accepts: Medica. Please consult your insurance carrier or call the provider to verify.
