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WALGREENS #05701
NPI 1467468850
Pharmacy in Mesa, AZ

Active since July 31, 2006CLIA 03D2063054 · Waiver
1158 S CRISMON RD, MESA, AZ 85208(480) 358-9642 Get Directions Write a Review

NPPES record last updated: April 28, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Apr 28, 2022, Nov 26, 2015 (2 updates tracked since 2015).

About Walgreens #05701 NPPES

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

WALGREENS #05701 (NPI 1467468850) is a healthcare organization registered as a pharmacy in Mesa, Arizona and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through October 17, 2027 and lists Kira L Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1467468850
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address1158 S CRISMON RDMesa, AZ 85208-2597
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Phone(480) 358-9642
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira L TaylorManager · (217) 709-2351
Enumeration DateJuly 31, 2006
Last NPPES UpdateApril 28, 20222 updates tracked since enumeration
NPPES CertifiedApril 28, 2022
✔ NPI 1467468850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in AZ · Y03389
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
1158 S CRISMON RD, Mesa, AZ 85208
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Other Names 1

Doing Business AsWalgreens #05701

Other Identifiers 2

Medicaid589525AZ
Other0325983Other Id Number-commercial Number

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 03D2063054

Walgreens #05701 · Mesa, AZ
Active · expires Oct 17, 2027
CLIA Number03D2063054
Laboratory TypePharmacy
Certificate Effective DateOctober 18, 2025
Certificate Expiration DateOctober 17, 2027
Laboratory DirectorMichael H. Mckown
Laboratory Phone(480) 358-9642
Laboratory LocationWalgreens #057011158 S Crismon Rd, Mesa, AZ 85208
CLIA data matches this NPI record on: Address Name Phone
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.
151 services151 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.
123 services123 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.
32 services32 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.
32 services32 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.
26 services26 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #05701 carries, from the Medicare DMEPOS supplier directory.

Walgreens #05701

DMEPOS supplier · Mesa, AZOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #05701 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)20394857
Medicare Participant SinceMarch 1, 2022
Supplier Location1158 S Crismon RdMesa, AZ 85208
Phone(480) 358-9642
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 3

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

DANIEL SALDIVAR PHARM.D
Pharmacist
1158 S CRISMON RD
MESA, AZ 85208
Maricopa County (480) 358-9642
UYEN-MINH T DAO
Pharmacist
1158 S CRISMON RD
MESA, AZ 85208
Maricopa County (480) 358-9642
DR. DUSANKA POTKONJAK
Pharmacist
1158 S CRISMON RD
MESA, AZ 85208
Maricopa County (480) 358-9642

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 1467468850. It was assigned to this organization in the NPPES registry on July 31, 2006. The provider is doing business as Walgreens #05701.

Where is Walgreen Co located?

Walgreen Co is located at 1158 S Crismon Rd, Mesa, AZ 85208. The listed phone number is (480) 358-9642.

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 #05701 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 03D2063054) is associated with this NPI, valid through October 17, 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 41 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 April 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.