WALGREEN CO
NPI 1467637868
Pharmacy in Bolivar, MO

Active since January 03, 2008CLIA 26D2038866 · Waiver
1820 S SPRINGFIELD AVE, BOLIVAR, MO 65613(417) 777-3700(417) 777-5553 Get Directions Write a Review

NPPES record last updated: November 20, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 20, 2025, Nov 9, 2023, Apr 5, 2019 and 3 more (6 updates tracked since 2016).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1467637868) is a healthcare organization registered as a pharmacy in Bolivar, Missouri and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through March 24, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1467637868
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address1820 S SPRINGFIELD AVEBolivar, MO 65613-2563
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Fax(417) 777-5553
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateJanuary 3, 2008
Last NPPES UpdateNovember 20, 20256 updates tracked since enumeration
NPPES CertifiedNovember 20, 2025
NPI 1467637868 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
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
1820 S SPRINGFIELD AVE, Bolivar, MO 65613

Other Names 1

Other NameWalgreens # 11666

Other Identifiers 2

Other2637772MO · Ncpdp
Medicaid606370500MO

Accepted 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 26D2038866

Walgreens #11666 · Bolivar, MO
Active · expires Mar 24, 2027
CLIA Number26D2038866
Laboratory TypePharmacy
Certificate Effective DateMarch 25, 2025
Certificate Expiration DateMarch 24, 2027
Laboratory DirectorGayla Otten
Laboratory Phone(417) 777-3700
Laboratory LocationWalgreens #116661820 S Springfield Ave, Bolivar, MO 65613
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 3

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.
179 services176 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.
105 services105 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.
53 services53 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #11666 carries, from the Medicare DMEPOS supplier directory.

Walgreens #11666

DMEPOS supplier · Bolivar, MOOperated by Walgreen Co

Accepts Medicare assignment

Walgreens #11666 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)20372477
Medicare Participant SinceMarch 1, 2022
Supplier Location1820 S Springfield AveBolivar, MO 65613
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.

Pharmacist
1820 S SPRINGFIELD AVE
BOLIVAR, MO 65613
Pharmacist
1820 S SPRINGFIELD AVE
BOLIVAR, MO 65613
Pharmacist
1820 S SPRINGFIELD AVE
BOLIVAR, MO 65613
Pharmacist
1820 S SPRINGFIELD AVE
BOLIVAR, MO 65613
Pharmacist
1820 S SPRINGFIELD AVE
BOLIVAR, MO 65613

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 1467637868. It was assigned to this organization in the NPPES registry on January 3, 2008. The provider is also known as Walgreens # 11666.

Where is Walgreen Co located?

Walgreen Co is located at 1820 S Springfield Ave, Bolivar, MO 65613. The listed phone number is (417) 777-3700.

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 #11666 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 26D2038866) is associated with this NPI, valid through March 24, 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 42 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 November 20, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.