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WALGREENS #21465
NPI 1427737949
Pharmacy in Tyler, TX

Active since July 12, 2023CLIA 45D0984878 · Waiver
2020 ROSELAND BLVD, TYLER, TX 75701(903) 597-1358 Get Directions Write a Review

NPPES record last updated: February 5, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 5, 2024, Sep 8, 2023, Jul 12, 2023 (3 updates tracked since 2023).

About Walgreens #21465 NPPES

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

WALGREENS #21465 (NPI 1427737949) is a healthcare organization registered as a pharmacy in Tyler, Texas and active in the NPI registry since July 2023. The organization holds a CLIA Waiver certificate valid through April 1, 2027 and lists Kira L Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1427737949
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO.
Location Address2020 ROSELAND BLVDTyler, TX 75701-4248
Mailing Address1901 E Voorhees St # Ms 790Danville, IL 61834-4509 · (217) 709-2351
Phone(903) 597-1358
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira L TaylorManager · (217) 709-2351
Enumeration DateJuly 12, 2023
Last NPPES UpdateFebruary 5, 20243 updates tracked since enumeration
NPPES CertifiedFebruary 5, 2024
✔ NPI 1427737949 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
2020 ROSELAND BLVD, Tyler, TX 75701
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Other Names 1

Doing Business AsWalgreens #21465

Other Identifiers 1

Medicaid471466TX

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 45D0984878

Walgreens 21465 · Tyler, TX
Active · expires Apr 1, 2027
CLIA Number45D0984878
Laboratory TypePharmacy
Certificate Effective DateApril 2, 2025
Certificate Expiration DateApril 1, 2027
Laboratory DirectorCody Gilbert
Laboratory Phone(903) 597-1358
Laboratory LocationWalgreens 214652020 Roseland Boulevard, Suite 101, Tyler, TX 75701
CLIA data matches this NPI record on: Address Name Phone
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 Walgreens #21465 carries, from the Medicare DMEPOS supplier directory.

Walgreens #21465

DMEPOS supplier · Tyler, TXOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #21465 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)20382017
Medicare Participant SinceMarch 1, 2022
Supplier Location2020 Roseland BoulevardTyler, TX 75701
Phone(903) 597-1358
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.

MR. JOHN STEVEN BRUNSON RPH
Pharmacist
2020 ROSELAND BLVD
TYLER, TX 75701
Smith County (903) 597-1358
BROOKSHIRE GROCERY COMPANY
Pharmacy (Community/Retail Pharmacy)
2020 ROSELAND BLVD, ATTENTION PHARMACY DEPT
TYLER, TX 75701
Smith County (903) 597-1358
DR. CHARLOTTE LEN WELLER PHARM.D.
Pharmacist
2020 ROSELAND BLVD
TYLER, TX 75701
Smith County (903) 597-1358
TERA MAYO
Pharmacist
2020 ROSELAND BLVD
TYLER, TX 75701
Smith County (903) 597-1358

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 1427737949. It was assigned to this organization in the NPPES registry on July 12, 2023. The provider is doing business as Walgreens #21465.

Where is Walgreen Co. located?

Walgreen Co. is located at 2020 Roseland Blvd, Tyler, TX 75701. The listed phone number is (903) 597-1358.

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 #21465 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 45D0984878) is associated with this NPI, valid through April 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 45 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 February 5, 2024. 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.