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WALGREENS #17784
NPI 1407379415
Pharmacy in Wytheville, VA

Active since July 21, 2017CLIA 49D2242941 · Waiver
150 N 11TH ST, WYTHEVILLE, VA 24382(276) 228-0637(276) 227-0203 Get Directions Write a Review

NPPES record last updated: May 16, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 16, 2022, Jan 20, 2020, May 1, 2018 and 4 more (7 updates tracked since 2017).

About Walgreens #17784 NPPES

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

WALGREENS #17784 (NPI 1407379415) is a healthcare organization registered as a pharmacy in Wytheville, Virginia and active in the NPI registry since July 2017. The organization holds a CLIA Waiver certificate valid through November 14, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1407379415
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address150 N 11TH STWytheville, VA 24382-2029
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Phone(276) 228-0637
Fax(276) 227-0203
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateJuly 21, 2017
Last NPPES UpdateMay 16, 20227 updates tracked since enumeration
NPPES CertifiedMay 16, 2022
✔ NPI 1407379415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
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
150 N 11TH ST, Wytheville, VA 24382
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Other Names 1

Doing Business AsWalgreens #17784

Other Identifiers 3

Other4849165VA · Ncpdp
Other0201003404VA · Board Of Pharmacy
Medicaid1407379415VA

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 49D2242941

Walgreens #17784 · Wytheville, VA
Active · expires Nov 14, 2027
CLIA Number49D2242941
Laboratory TypePharmacy
Certificate Effective DateNovember 15, 2025
Certificate Expiration DateNovember 14, 2027
Laboratory DirectorJonathan Ritchie
Laboratory Phone(276) 228-0637
Laboratory LocationWalgreens #17784150 North 11th Street, Wytheville, VA 24382
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 5

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.
242 services242 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.
145 services145 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.
88 services88 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.
35 services35 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.
35 services35 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #17784 carries, from the Medicare DMEPOS supplier directory.

Walgreens #17784

DMEPOS supplier · Wytheville, VAOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #17784 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)20401853
Medicare Participant SinceMarch 1, 2022
Supplier Location150 N 11th StWytheville, VA 24382
Phone(276) 228-0637
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.

BRANDON FLETCHER
Pharmacist
150 N 11TH ST
WYTHEVILLE, VA 24382
Wythe County (276) 228-0637
DARREN B JONES B.S.
Pharmacist
150 N 11TH ST
WYTHEVILLE, VA 24382
Wythe County (276) 228-0637
BETHANY SAWYERS PHARMD
Pharmacist
150 N 11TH ST
WYTHEVILLE, VA 24382
Wythe County (276) 245-5648
MARY CRAWFORD PHARMD
Pharmacist
150 N 11TH ST
WYTHEVILLE, VA 24382
Wythe County (276) 228-0637

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 1407379415. It was assigned to this organization in the NPPES registry on July 21, 2017.

Where is Walgreen Co located?

Walgreen Co is located at 150 N 11th St, Wytheville, VA 24382. The listed phone number is (276) 228-0637.

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 #17784 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 49D2242941) is associated with this NPI, valid through November 14, 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 May 16, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.