WALGREEN CO
NPI 1366458002
Pharmacy in Mesa, AZ

Active since August 01, 2006CLIA 03D2073689 · Waiver
1935 N POWER RD, MESA, AZ 85205(480) 985-3658 Get Directions Write a Review

NPPES record last updated: June 16, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 16, 2025, Oct 25, 2023, Mar 7, 2022 and 1 more (4 updates tracked since 2015).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1366458002), doing business as Walgreens #03215, is a healthcare organization registered as a pharmacy in Mesa, Arizona and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through July 13, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1366458002
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address1935 N POWER RDMesa, AZ 85205-3728
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (847) 527-2489 · Fax (217) 709-2344
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateAugust 1, 2006
Last NPPES UpdateJune 16, 20254 updates tracked since enumeration
NPPES CertifiedJune 16, 2025
NPI 1366458002 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in AZ · YO2726
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
1935 N POWER RD, Mesa, AZ 85205

Other Names 1

Doing Business AsWalgreens #03215

Other Identifiers 2

Other0321290Other Id Number-commercial Number
Medicaid317356AZ

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 03D2073689

Walgreens #03215 · Mesa, AZ
Active · expires Jul 13, 2027
CLIA Number03D2073689
Laboratory TypePharmacy
Certificate Effective DateJuly 14, 2025
Certificate Expiration DateJuly 13, 2027
Laboratory DirectorAcacia Jackson
Laboratory Phone(480) 985-3658
Laboratory LocationWalgreens #032151935 N Power Rd, Mesa, AZ 85205
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 6

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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.
288 services282 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.
155 services155 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.
106 services106 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.
70 services70 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.
70 services70 patients
Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage 90694
The quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.
16 services16 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #3215 carries, from the Medicare DMEPOS supplier directory.

Walgreens #3215

DMEPOS supplier · Mesa, AZOperated by Walgreen Co

Accepts Medicare assignment

Walgreens #3215 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)20361497
Medicare Participant SinceMarch 1, 2022
Supplier Location1935 N Power RdMesa, AZ 85205
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 6

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

Pharmacist
1935 N POWER RD
MESA, AZ 85205
Student in an Organized Health Care Education/Training Program
1935 N POWER RD
MESA, AZ 85205
Pharmacist
1935 N POWER RD
MESA, AZ 85205
Pharmacist
1935 N POWER RD
MESA, AZ 85205
Pharmacist
1935 N POWER RD
MESA, AZ 85205
Pharmacist
1935 N POWER RD
MESA, AZ 85205

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1366458002, enumerated as an "organization" on August 01, 2006.

The provider is located at 1935 N POWER RD MESA, AZ 85205 and the phone number is (480) 985-3658.

Pharmacy with taxonomy code 333600000X.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.