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WALGREENS CO.
NPI 1457804205
Pharmacy - Community/Retail Pharmacy in Mineola, NY

Active since July 28, 2016CLIA 33D2237041 · Waiver
12 E JERICHO TPKE, MINEOLA, NY 11501(516) 739-2408 Get Directions Write a Review

NPPES record last updated: July 28, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Walgreens Co. NPPES

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

WALGREENS CO. (NPI 1457804205) is a healthcare organization registered as a community/retail pharmacy in Mineola, New York and active in the NPI registry since July 2016. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Claudio Sousa Dematos, Pharmacist, as its authorized official.

NPPES Registry Identity

NPI1457804205
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWALGREENS CO.
Location Address12 E JERICHO TPKEMineola, NY 11501-3141
Mailing Address1803 Adlin CtEast Meadow, NY 11554-1656 · (516) 376-8780
Phone(516) 739-2408
Organization SubpartNo
Authorized OfficialClaudio Sousa DematosPharmacist · (516) 376-8780
Enumeration DateJuly 28, 2016
✔ NPI 1457804205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in NY · 061846
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
12 E JERICHO TPKE, Mineola, NY 11501
Open in Google Maps ↗

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 33D2237041

Walgreens No 13961 · Mineola, NY
Active · expires Mar 26, 2027
CLIA Number33D2237041
Laboratory TypePharmacy
Certificate Effective DateSeptember 22, 2021
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Zeiad Fakhovri
Laboratory Phone(516) 739-2408
Laboratory LocationWalgreens No 1396112 E Jericho Tpke, Mineola, NY 11501
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 Walgreen Co carries, from the Medicare DMEPOS supplier directory.

Walgreen Co

DMEPOS supplier · Mineola, NY
✔

Accepts Medicare assignment

Walgreen Co 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)20396177
Medicare Participant SinceMarch 1, 2022
Supplier Location12 E Jericho TpkeMineola, NY 11501
Phone(516) 739-2408
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 6

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

MAZAL DAVYDOVA
Pharmacist
12 E JERICHO TPKE
MINEOLA, NY 11501
Nassau County (347) 545-6346
RIYA RAJU
Pharmacist
12 E JERICHO TPKE
MINEOLA, NY 11501
Nassau County (516) 739-2408
DR. GURMINDER KAUR
Pharmacist
12 E JERICHO TPKE
MINEOLA, NY 11501
Nassau County (516) 739-2408
NATANNIEL BADALOV PHARMD
Pharmacist
12 E JERICHO TPKE
MINEOLA, NY 11501
Nassau County (718) 915-3743
ADELE ELIZABETH COVELLI
Pharmacist
12 E JERICHO TPKE
MINEOLA, NY 11501
Nassau County (516) 739-2408
WALGREEN CO
Pharmacy
12 E JERICHO TPKE
MINEOLA, NY 11501
Nassau County (516) 739-2408

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 Walgreens Co.'s NPI number?

The NPI number for Walgreens Co. is 1457804205. It was assigned to this organization in the NPPES registry on July 28, 2016.

Where is Walgreens Co. located?

Walgreens Co. is located at 12 E Jericho Tpke, Mineola, NY 11501. The listed phone number is (516) 739-2408.

What is Walgreens Co.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Walgreens Co. accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Walgreen Co accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Walgreens Co. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2237041) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Walgreens Co. was last updated on July 28, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.