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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 1417472655
Pharmacy in Waterloo, NY

Active since August 09, 2017CLIA 33D2240899 · Waiver
1929 US ROUTE 20, WATERLOO, NY 13165(315) 539-5056(315) 539-9347 Get Directions Write a Review

NPPES record last updated: June 24, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 10, 2022, Oct 30, 2019, Aug 10, 2018 and 2 more (5 updates tracked since 2017).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1417472655), doing business as Walgreens #19876, is a healthcare organization registered as a pharmacy in Waterloo, New York and active in the NPI registry since August 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

NPI1417472655
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address1929 US ROUTE 20Waterloo, NY 13165-9453
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Phone(315) 539-5056
Fax(315) 539-9347
Organization SubpartYesParent: Walgreens Holding Company
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateAugust 9, 2017
Last NPPES UpdateJune 24, 20265 updates tracked since enumeration
NPPES CertifiedJune 24, 2026
✔ NPI 1417472655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in NY · 036238
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
1929 US ROUTE 20, Waterloo, NY 13165
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Other Names 1

Doing Business AsWalgreens #19876

Other Identifiers 2

Other5822805NY · Ncpdp
Medicaid05072459NY

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 33D2240899

Walgreens No 19876 · Waterloo, NY
Active · expires Mar 26, 2027
CLIA Number33D2240899
Laboratory TypePharmacy
Certificate Effective DateOctober 22, 2021
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Zeiad A. Fakhouri
Laboratory Phone(315) 539-5056
Laboratory LocationWalgreens No 198761929 Us Rte 20, Waterloo, NY 13165
CLIA data matches this NPI record on: 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.
186 services186 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.
109 services109 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.
58 services58 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.
13 services13 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.
13 services13 patients

Other Providers at the Same Location NPPES 5

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

ASHLEY COFFEY
Pharmacist
1929 US ROUTE 20
WATERLOO, NY 13165
Seneca County (315) 539-5056
COURTNEY JOHNSON
Pharmacist
1929 US ROUTE 20
WATERLOO, NY 13165
Seneca County (315) 539-5056
ROSIE CALLAGHAN
Pharmacist
1929 US ROUTE 20
WATERLOO, NY 13165
Seneca County (315) 539-5056
MOHINI RATHOD
Pharmacist
1929 US ROUTE 20
WATERLOO, NY 13165
Seneca County (315) 573-8363
ELIZABETH FEY PHARMD
Pharmacist
1929 US ROUTE 20
WATERLOO, NY 13165
Seneca County (315) 539-5056

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 1417472655. It was assigned to this organization in the NPPES registry on August 9, 2017. The provider is doing business as Walgreens #19876.

Where is Walgreen Co located?

Walgreen Co is located at 1929 Us Route 20, Waterloo, NY 13165. The listed phone number is (315) 539-5056.

What is Walgreen Co's specialty?

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

Does Walgreen Co hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2240899) is associated with this NPI, valid through March 26, 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 June 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 58 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.