WALGREEN CO
NPI 1366544702
Pharmacy in Dexter, MO

Active since September 05, 2006CLIA 26D2217626 · Waiver
904 W BUSINESS US HIGHWAY 60, DEXTER, MO 63841(573) 624-7452(573) 624-6867 Get Directions Write a Review

NPPES record last updated: August 8, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 8, 2025, May 3, 2022, Apr 8, 2019 and 4 more (7 updates tracked since 2016).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1366544702), doing business as Walgreens #15800, is a healthcare organization registered as a pharmacy in Dexter, Missouri and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through March 22, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1366544702
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address904 W BUSINESS US HIGHWAY 60Dexter, MO 63841-2701
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Fax(573) 624-6867
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateSeptember 5, 2006
Last NPPES UpdateAugust 8, 20257 updates tracked since enumeration
NPPES CertifiedAugust 8, 2025
NPI 1366544702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in MO · 2017006071
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
904 W BUSINESS US HIGHWAY 60, Dexter, MO 63841

Other Names 1

Doing Business AsWalgreens #15800

Other Identifiers 2

Other2613443Ncpdp Provider Identification Number
Medicaid600307201MO

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 26D2217626

Walgreens #15800 · Dexter, MO
Active · expires Mar 22, 2027
CLIA Number26D2217626
Laboratory TypePharmacy
Certificate Effective DateMarch 23, 2025
Certificate Expiration DateMarch 22, 2027
Laboratory DirectorWilliam W. Simmons
Laboratory Phone(573) 624-7452
Laboratory LocationWalgreens #15800904 W Business Us Highway 60, Dexter, MO 63841
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #15800 carries, from the Medicare DMEPOS supplier directory.

Walgreens #15800

DMEPOS supplier · Dexter, MOOperated by Walgreen Co

Accepts Medicare assignment

Walgreens #15800 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)20379521
Medicare Participant SinceMarch 1, 2022
Supplier Location904 W Business Us Hwy 60Dexter, MO 63841
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 4

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

Pharmacist
904 W BUSINESS US HIGHWAY 60
DEXTER, MO 63841
Pharmacist
904 W BUSINESS US HIGHWAY 60
DEXTER, MO 63841
Pharmacist
904 W BUSINESS US HIGHWAY 60
DEXTER, MO 63841
Pharmacy (Community/Retail Pharmacy)
904 W BUSINESS US HIGHWAY 60
DEXTER, MO 63841

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 1366544702. It was assigned to this organization in the NPPES registry on September 5, 2006. The provider is doing business as Walgreens #15800.

Where is Walgreen Co located?

Walgreen Co is located at 904 W Business Us Highway 60, Dexter, MO 63841. The listed phone number is (573) 624-7452.

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 #15800 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 26D2217626) is associated with this NPI, valid through March 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 42 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 August 8, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.