Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

WALGREEN CO
NPI 1366966632
Pharmacy in Syracuse, NY

Q: What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1366966632. It was assigned to this organization in the NPPES registry on July 28, 2017. The provider is doing business as Walgreens #19549.

Q: What is Walgreen Co's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Q: When was this NPI record last updated?

The NPPES record for Walgreen Co was last updated on June 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 49 days 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.

Active since July 28, 2017CLIA 33D2240921 · Waiver

4751 ONONDAGA BLVD, SYRACUSE, NY 13219(315) 476-2141(315) 475-8632 Get Directions Write a Review

NPPES record last updated: June 24, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 9, 2022, Apr 23, 2019, Aug 9, 2018 and 5 more (8 updates tracked since 2017).

On this page

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1366966632), doing business as Walgreens #19549, is a healthcare organization registered as a pharmacy in Syracuse, New York and active in the NPI registry since July 2017. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1366966632

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address4751 ONONDAGA BLVDSyracuse, NY 13219-3315

Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344

Phone(315) 476-2141

Fax(315) 475-8632

Organization SubpartYesParent: Walgreens Holding Company

Authorized OfficialKira TaylorManager · (217) 709-2351

Enumeration DateJuly 28, 2017

Last NPPES UpdateJune 24, 20268 updates tracked since enumeration

NPPES CertifiedJune 24, 2026

✔ NPI 1366966632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in NY · 036290

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

4751 ONONDAGA BLVD, Syracuse, NY 13219

Open in Google Maps ↗

Other Names 1

Doing Business AsWalgreens #19549

Other Identifiers 2

Medicaid05019021NY

Other5823186NY · Ncpdp

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 33D2240921

Walgreens No 19549 · Syracuse, NY

Active · expires Mar 26, 2027

CLIA Number33D2240921

Laboratory TypePharmacy

Certificate Effective DateOctober 22, 2021

Certificate Expiration DateMarch 26, 2027

Laboratory DirectorDr. Zeiad A. Fakhouri

Laboratory Phone(315) 476-2141

Laboratory LocationWalgreens No 195494751 Onondaga Blvd, Syracuse, NY 13219

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 services76 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.

42 services42 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.

26 services26 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #19549 carries, from the Medicare DMEPOS supplier directory.

Walgreens #19549

DMEPOS supplier · Syracuse, NYOperated by Walgreen Co

✔

Accepts Medicare assignment

Walgreens #19549 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)20380319

Medicare Participant SinceMarch 1, 2022

Supplier Location4751 Onondaga BlvdSyracuse, NY 13219

Phone(315) 476-2141

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 10

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

DR. LAUREN WILKINS PHARMD

Pharmacist