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WALGREENS SPECIALTY PHARMACY #21180
NPI 1407069610
Pharmacy in Waterbury, CT

Active since May 07, 2007CLIA 07D2241771 · Waiver
60 BANK ST STE 100, WATERBURY, CT 06702(203) 753-1116(203) 753-1117 Get Directions Write a Review

NPPES record last updated: November 6, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 6, 2024, Feb 8, 2019, Oct 16, 2018 and 2 more (5 updates tracked since 2016).

About Walgreens Specialty Pharmacy #21180 NPPES

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

WALGREENS SPECIALTY PHARMACY #21180 (NPI 1407069610) is a healthcare organization registered as a pharmacy in Waterbury, Connecticut and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through November 1, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1407069610
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address60 BANK ST STE 100Waterbury, CT 06702-2203
Mailing Address1901 E Voorhees St, Ms #790Danville, IL 61834-4509 · (847) 527-2489 · Fax (217) 709-2344
Phone(203) 753-1116
Fax(203) 753-1117
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateMay 7, 2007
Last NPPES UpdateNovember 6, 20245 updates tracked since enumeration
NPPES CertifiedNovember 6, 2024
✔ NPI 1407069610 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in CT · PCY0001723
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
60 BANK ST STE 100, Waterbury, CT 06702
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Other Names 1

Doing Business AsWalgreens Specialty Pharmacy #21180

Other Identifiers 3

Medicaid004269842CT
Medicaid004269850CT
Other0720777Ncpdp

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 07D2241771

Walgreens # 03192 · Waterbury, CT
Active · expires Nov 1, 2027
CLIA Number07D2241771
Laboratory TypePharmacy
Certificate Effective DateNovember 2, 2025
Certificate Expiration DateNovember 1, 2027
Laboratory DirectorAlexander M. West Rph
Laboratory Phone(203) 757-6010
Laboratory LocationWalgreens # 03192649 West Main St, Waterbury, CT 06702
CLIA data matches this NPI record on: Name
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 Walgreen Co carries, from the Medicare DMEPOS supplier directory.

Walgreen Co

DMEPOS supplier · Waterbury, CT
✔

Accepts Medicare assignment

Walgreen Co 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)20355785
Medicare Participant SinceMarch 1, 2022
Supplier Location60 Bank St Ste 100, Community Walgreens Pharmacy 21180Waterbury, CT 06702
Phone(203) 753-1116
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.

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 1407069610. It was assigned to this organization in the NPPES registry on May 7, 2007. The provider is doing business as Walgreens Specialty Pharmacy #21180.

Where is Walgreen Co located?

Walgreen Co is located at 60 Bank St Ste 100, Waterbury, CT 06702. The listed phone number is (203) 753-1116.

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, Walgreen Co 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 07D2241771) is associated with this NPI, valid through November 1, 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 38 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 November 6, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.