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WALGREENS #13854
NPI 1356633531
Pharmacy in Mount Olive, NC

Active since May 06, 2011CLIA 34D2031197 · Waiver
1103 N BREAZEALE AVE, MOUNT OLIVE, NC 28365(919) 658-8510(919) 658-9582 Get Directions Write a Review

NPPES record last updated: April 13, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 13, 2022, Nov 13, 2015 (2 updates tracked since 2015).

About Walgreens #13854 NPPES

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

WALGREENS #13854 (NPI 1356633531) is a healthcare organization registered as a pharmacy in Mount Olive, North Carolina and active in the NPI registry since May 2011. The organization holds a CLIA Waiver certificate valid through April 22, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1356633531
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address1103 N BREAZEALE AVEMount Olive, NC 28365
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Phone(919) 658-8510
Fax(919) 658-9582
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateMay 6, 2011
Last NPPES UpdateApril 13, 20222 updates tracked since enumeration
NPPES CertifiedApril 13, 2022
✔ NPI 1356633531 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in NC · 11038
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
1103 N BREAZEALE AVE, Mount Olive, NC 28365
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Other Names 1

Doing Business AsWalgreens #13854

Other Identifiers 2

Other3458848NC · Ncpdp
Medicaid0965790NC

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 34D2031197

Walgreens #13854 · Mount Olive, NC
Active · expires Apr 22, 2027
CLIA Number34D2031197
Laboratory TypePharmacy
Certificate Effective DateApril 23, 2025
Certificate Expiration DateApril 22, 2027
Laboratory DirectorRonald J. Pate
Laboratory Phone(919) 658-8510
Laboratory LocationWalgreens #138541103 North Breazeale Avenue, Mount Olive, NC 28365
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.
76 services75 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.
37 services36 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.
35 services35 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #13854 carries, from the Medicare DMEPOS supplier directory.

Walgreens #13854

DMEPOS supplier · Mount Olive, NCOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #13854 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)20388029
Medicare Participant SinceMarch 1, 2022
Supplier Location1103 N Breazeale AveMount Olive, NC 28365
Phone(919) 658-8510
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 3

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

DR. RONALD JACK PATE PHARMD
Pharmacist
1103 N BREAZEALE AVE
MOUNT OLIVE, NC 28365
Wayne County (910) 263-6074
DR. JESSI BROOKE MORGAN PHARMD
Pharmacist
1103 N BREAZEALE AVE
MOUNT OLIVE, NC 28365
Wayne County (919) 658-8510
EDGBERT RAY MCLEMORE JR. RPH
Pharmacist
1103 N BREAZEALE AVE
MT OLIVE, NC 28365
Wayne County (919) 658-8510

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 1356633531. It was assigned to this organization in the NPPES registry on May 6, 2011. The provider is doing business as Walgreens #13854.

Where is Walgreen Co located?

Walgreen Co is located at 1103 N Breazeale Ave, Mount Olive, NC 28365. The listed phone number is (919) 658-8510.

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 #13854 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 34D2031197) is associated with this NPI, valid through April 22, 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 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 April 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.