WALGREENS #07114
NPI 1467467415
Pharmacy in Glen Allen, VA

Q: What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1467467415. It was assigned to this organization in the NPPES registry on July 29, 2006. The provider is doing business as Walgreens #07114.

Q: What is Walgreen Co's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Walgreen Co was last updated on October 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.

Active since July 29, 2006CLIA Certified · 2 labs

11300 NUCKOLS RD, GLEN ALLEN, VA 23059(804) 270-4683 Get Directions Write a Review

NPPES record last updated: October 8, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 8, 2024, May 13, 2022, Dec 22, 2015 (3 updates tracked since 2015).

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About Walgreens #07114 NPPES

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

WALGREENS #07114 (NPI 1467467415) is a healthcare organization registered as a pharmacy in Glen Allen, Virginia and active in the NPI registry since July 2006. The organization holds 2 active CLIA laboratory certificates and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1467467415

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address11300 NUCKOLS RDGlen Allen, VA 23059-5503

Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (847) 527-2489 · Fax (217) 709-2344

Phone(804) 270-4683

Organization SubpartYesParent: Walgreens Boots Alliance Inc

Authorized OfficialJennifer PonceManager · (847) 527-2489

Enumeration DateJuly 29, 2006

Last NPPES UpdateOctober 8, 20243 updates tracked since enumeration

NPPES CertifiedOctober 8, 2024

✔ NPI 1467467415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in VA · 201003832

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

11300 NUCKOLS RD, Glen Allen, VA 23059

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Other Names 1

Doing Business AsWalgreens #07114

Other Identifiers 4

Medicaid156808407AR

Other4837285Other Id Number-commercial Number

Medicaid1226181LA

Medicaid008519676VA

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 2

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 49D2043700

Walgreens #7114 · Glen Allen, VA

Active · expires Jan 9, 2028

CLIA Number49D2043700

Laboratory TypePharmacy

Certificate Effective DateJanuary 10, 2026

Certificate Expiration DateJanuary 9, 2028

Laboratory DirectorSamah Mohamed

Laboratory Phone(804) 270-4683

Laboratory LocationWalgreens #711411300 Nuckols Road, Glen Allen, VA 23059

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2012698

Walgreens 02732 · Glen Allen, VA

Active · expires Dec 21, 2026

CLIA Number49D2012698

Laboratory TypePhysician Office

Certificate Effective DateDecember 22, 2024

Certificate Expiration DateDecember 21, 2026

Laboratory DirectorJamie L. Haight

Laboratory Phone(804) 264-9587

Laboratory LocationWalgreens 027329801 Brook Road, Glen Allen, VA 23059

CLIA data matches this NPI record on: Name

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.

187 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.

122 services122 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.

56 services56 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.

27 services27 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.

26 services26 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #7114 carries, from the Medicare DMEPOS supplier directory.

Walgreens #7114

DMEPOS supplier · Glen Allen, VAOperated by Walgreen Co

✔

Accepts Medicare assignment

Walgreens #7114 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)20363909

Medicare Participant SinceMarch 1, 2022

Supplier Location11300 Nuckols RdGlen Allen, VA 23059

Phone(804) 270-4683

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 5

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

KAITLIN LEE

Pharmacist