WALGREENS #10540
NPI 1457541427
Pharmacy in De Soto, MO

Active since July 26, 2007CLIA 26D2038837 · Waiver
12977 STATE ROUTE 21, DE SOTO, MO 63020(636) 586-8779(636) 586-1994 Get Directions Write a Review

NPPES record last updated: November 9, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 9, 2023, Mar 9, 2022, Jun 15, 2018 and 1 more (4 updates tracked since 2018).

About Walgreens #10540 NPPES

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

WALGREENS #10540 (NPI 1457541427) is a healthcare organization registered as a pharmacy in De Soto, Missouri and active in the NPI registry since July 2007. The organization holds a CLIA Waiver certificate valid through March 24, 2027 and lists Kira Taylor, Manager, as its authorized official.Information from the official NPPES registry record, last updated November 9, 2023.

NPPES Registry Identity

NPI1457541427
Entity TypeOrganization
Legal Business NameWALGREEN CO
Location Address12977 STATE ROUTE 21De Soto, MO 63020-1000
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Fax(636) 586-1994
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateJuly 26, 2007
Last NPPES UpdateNovember 9, 20234 updates tracked since enumeration
NPPES CertifiedNovember 9, 2023
NPI 1457541427 is a valid, active identifier and passes the ISO check-digit test. How NPI validation works

Primary Specialty

Pharmacy

Taxonomy 333600000X · Suppliers

Licensed in MO · 2007024886

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a… Show more

Also Listed

Pharmacy · Community/Retail Pharmacy

Taxonomy 3336C0003X · Suppliers

12977 STATE ROUTE 21, De Soto, MO 63020

Also on File with NPPES

Other Names1
Walgreens #10540 (Doing Business As)
Other Identifiers3
2637479 (Other, Ncpdp)
626333504 DME (Medicaid, MO)
606333508 (Medicaid, MO)

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of influenza virus vaccine

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.

This service was performed 143 times for 141 patients

Influenza vaccine split virus, preservative free

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.

This service was performed 87 times for 86 patients

Influenza vaccine, inactivated

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.

This service was performed 48 times for 48 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20371421
Accepts Medicare Assignment
YES
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • 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
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

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
26D2038837
Facility Type
Pharmacy
Certificate Effective Date
March 25, 2025
Certificate Expiration Date
March 24, 2027
Laboratory Director
BLAKE A. STEIGHORST
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Walgreens #10540 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.

Reviews for WALGREENS #10540

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Pharmacist
12977 STATE ROUTE 21
DE SOTO, MO 63020

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1457541427, enumerated as an "organization" on July 26, 2007.

The provider is located at 12977 STATE ROUTE 21 DE SOTO, MO 63020 and the phone number is (636) 586-8779.

Pharmacy with taxonomy code 333600000X.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.