WALGREENS #21435
NPI 1457088825
Pharmacy in West Jordan, UT
NPI Status: Active since August 04, 2022
Contact Information
4701 W 6200 SOUTH
WEST JORDAN, UT
ZIP 84084
Phone: (217) 709-2351
- Organization
- Pharmacy
- Accepts Insurance
- CLIA Number: 46D2011525
- CLIA Cert. Type: Pharmacy
- CLIA Exp. Date: 04-06-2027
About WALGREENS #21435
This page provides the complete NPI Profile along with additional information for Walgreens #21435, a provider established in West Jordan, Utah operating as a Pharmacy. The healthcare provider is registered in the NPI registry with number 1457088825 assigned on August 2022. The practitioner's primary taxonomy code is 333600000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Walgreens #21435. The authorized official of this NPI record is Kira L Taylor (Manager)
- NPI
- 1457088825
- Provider Legal Name
- WALGREEN CO.
- Other Organization Name
- WALGREENS #21435
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4701 W 6200 SOUTH WEST JORDAN, UT 84084
- Location Phone
- (217) 709-2351
- Mailing Address
- 1901 E VOORHEES ST # MS 790 DANVILLE, IL 61834
- Mailing Phone
- (217) 709-2351
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 08-04-2022
- Last Update Date
- 08-17-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy
- Taxonomy Code
- 333600000X
- Type
- Suppliers
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
| 2 | 3336C0003X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Catastrophic Standard - HMO
- Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- ConnectPlus $0 Gold - PPO
- ConnectPlus $0 Silver - PPO
- ConnectPlus $10,600 HSA Eligible HDHP - PPO
- ConnectPlus $1800 - PPO
- ConnectPlus $4500 - PPO
- ConnectPlus $6500 HSA Eligible HDHP - PPO
- ConnectPlus $7500 HSA Eligible HDHP - PPO
- ConnectPlus MyWeighForward $2000 - PPO
- ConnectPlus MyWeighForward $6000 - PPO
- ConnectPlus Standard $2000 - PPO
- ConnectPlus Standard $6000 - PPO
- ConnectPlus Standard $7500 HSA Eligible HDHP - PPO
- DirectConnect $0 Gold - HMO
- DirectConnect $0 Silver - HMO
- DirectConnect $1800 - HMO
- DirectConnect $4500 - HMO
- DirectConnect $6500 HSA Eligible HDHP - HMO
- DirectConnect $7500 HSA Eligible HDHP - HMO
- DirectConnect MyWeighForward $2000 - HMO
- DirectConnect MyWeighForward $6000 - HMO
- BSW Diabetes Care Gold HMO 014 - HMO
- BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Elite Gold HMO 004 - HMO
- BSW Elite Gold HMO 012 - HMO
- BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Prime Silver HMO 008 - HMO
- BSW Prime Silver HMO 005 - HMO
- BSW Savers Bronze HMO H S A 006 - HMO
- BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Savers Bronze HMO H S A 009 - HMO
- Blue KC Catastrophic BlueSelect EPO - EPO
- Blue KC Choice Bronze 2 with Spira Care BlueSelect EPO - EPO
- Blue KC Choice Silver 1 with Spira Care BlueSelect EPO - EPO
- Blue KC Community Silver Preferred-Care Blue EPO - EPO
- Blue KC First Bronze Preferred-Care Blue EPO - EPO
- Blue KC Simply Blue Bronze with Spira Care Blue Metro EPO - EPO
- Blue KC Simply Blue Gold with Spira Care Blue Metro EPO - EPO
- Blue KC Simply Blue Silver with Spira Care Blue Metro EPO - EPO
- Blue KC Standard Bronze BlueSelect EPO - EPO
- Blue KC Standard Bronze Preferred-Care Blue EPO - EPO
- Blue KC Standard Gold BlueSelect EPO - EPO
- Blue KC Standard Gold Preferred-Care Blue EPO - EPO
- Blue KC Standard Silver BlueSelect EPO - EPO
- Blue KC Standard Silver Preferred-Care Blue EPO - EPO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- Select by Medica Bronze $0 Copay PCP Visits - EPO
- Select by Medica Bronze Share - EPO
- Select by Medica Expanded Bronze Standard - EPO
- Select by Medica Gold $0 Copay PCP Visits - EPO
- Select by Medica Gold Share - EPO
- Select by Medica Gold Standard - EPO
- Select by Medica Silver $0 Copay PCP Visits - EPO
- Select by Medica Silver Share - EPO
- Select by Medica Silver Standard - EPO
- Connect 1500 Gold - EPO
- Connect 6000 Silver - EPO
- Connect 9800 Bronze - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded (Dental + Vision) - HMO
- UHC Bronze Essential - HMO
- UHC Bronze Essential- - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
- UHC Bronze Essential- ($0 Virtual Urgent Care) - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Essential (No Referrals) - EPO
- UHC Bronze Essential (No Referrals) - HMO
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay Office Visits - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay Office Visits - EPO
- Healthy Premier Silver Standard - EPO
- U Health Plus Bronze - EPO
- U Health Plus Expanded Bronze Standard - EPO
- U Health Plus Gold - EPO
- U Health Plus Gold Standard - EPO
- U Health Plus Silver - EPO
- U Health Plus Silver Standard - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 46D2011525
- Facility Type
- Pharmacy
- Certificate Effective Date
- April 07, 2025
- Certificate Expiration Date
- April 06, 2027
- Laboratory Director
- ASHLEY L. BYZARD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Walgreens #21435 to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1457088825, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1457088825, enumerated as an "organization" on August 04, 2022.
The provider is located at 4701 W 6200 SOUTH WEST JORDAN, UT 84084 and the phone number is (217) 709-2351.
Pharmacy with taxonomy code 333600000X.
The provider might be accepting Accepts: Antidote Health Plan of Arizona, Inc., Antidote. Please consult your insurance carrier or call the provider to verify.
