WALGREENS #11643
NPI 1417105891
Pharmacy in Eugene, OR

Q: What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1417105891. It was assigned to this organization in the NPPES registry on August 28, 2008. The provider is doing business as Walgreens #11643.

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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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 August 28, 2008CLIA 38D2217941 · Waiver

1675 COBURG RD, EUGENE, OR 97401(541) 344-0015(541) 344-4946 Get Directions Write a Review

NPPES record last updated: November 3, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 3, 2023, Dec 11, 2020, Aug 17, 2016 and 1 more (4 updates tracked since 2016).

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About Walgreens #11643 NPPES

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

WALGREENS #11643 (NPI 1417105891) is a healthcare organization registered as a pharmacy in Eugene, Oregon and active in the NPI registry since August 2008. The organization holds a CLIA Waiver certificate valid through March 23, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1417105891

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address1675 COBURG RDEugene, OR 97401-4854

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

Phone(541) 344-0015

Fax(541) 344-4946

Organization SubpartYesParent: Walgreens Boots Alliance Inc

Authorized OfficialKira TaylorManager · (217) 709-2351

Enumeration DateAugust 28, 2008

Last NPPES UpdateNovember 3, 20234 updates tracked since enumeration

NPPES CertifiedNovember 3, 2023

✔ NPI 1417105891 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in OR · RP-0002501-CS

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

1675 COBURG RD, Eugene, OR 97401

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Other Names 1

Doing Business AsWalgreens #11643

Other Identifiers 3

Other3843287Ncpdp

Other500602014OR · Medicaid Dme

Medicaid246753OR

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 38D2217941

Walgreens #11643 · Eugene, OR

Active · expires Mar 23, 2027

CLIA Number38D2217941

Laboratory TypePharmacy

Certificate Effective DateMarch 24, 2025

Certificate Expiration DateMarch 23, 2027

Laboratory DirectorTed Hoggard

Laboratory Phone(541) 344-0015

Laboratory LocationWalgreens #116431675 Coburg Rd, Eugene, OR 97401

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.

162 services162 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.

123 services123 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.

29 services29 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #11643 carries, from the Medicare DMEPOS supplier directory.

Walgreens #11643

DMEPOS supplier · Eugene, OROperated by Walgreen Co

✔

Accepts Medicare assignment

Walgreens #11643 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)20370449

Medicare Participant SinceMarch 1, 2022

Supplier Location1675 Coburg RdEugene, OR 97401

Phone(541) 344-0015

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.

SUMEIA M MOHAMED I

Pharmacist