WALGREENS #03633 - NPI 1407863400 - Pharmacy in Moline, IL

Q: What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1407863400. It was assigned to this organization in the NPPES registry on August 2, 2006. The provider is doing business as Walgreens #03633.

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 November 3, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Walgreens #03633 NPPES

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

WALGREENS #03633 (NPI 1407863400) is a healthcare organization registered as a pharmacy in Moline, Illinois and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through January 26, 2027 and lists Kira L Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1407863400

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address4000 AVENUE OF THE CITIESMoline, IL 61265-4400

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

Phone(309) 797-2588

Fax(309) 762-9145

Organization SubpartYesParent: Walgreens Boots Alliance Inc

Authorized OfficialKira L TaylorManager · (217) 709-2351

Enumeration DateAugust 2, 2006

Last NPPES UpdateNovember 3, 20232 updates tracked since enumeration

NPPES CertifiedNovember 3, 2023

✔ NPI 1407863400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in IL · 054.019231

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

4000 AVENUE OF THE CITIES, Moline, IL 61265

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Other Names 1

Doing Business AsWalgreens #03633

Other Identifiers 2

Other1402990Other Id Number-commercial Number

Medicaid0955914IA

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 14D2015082

Walgreens # 03633 · Moline, IL

Active · expires Jan 26, 2027

CLIA Number14D2015082

Laboratory TypeCovid Testing

Certificate Effective DateJanuary 27, 2025

Certificate Expiration DateJanuary 26, 2027

Laboratory DirectorCraig Ford

Laboratory Phone(309) 797-2588

Laboratory LocationWalgreens # 036334000 Avenue Of The Cities, Moline, IL 61265

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.

139 services137 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.

72 services72 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.

52 services52 patients

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.

AMANDA ALEJANDRIA PHARMD

Pharmacist