WALGREEN CO
NPI 1487669511
Pharmacy in Indianapolis, IN

Active since July 29, 2006CLIA 15D2011466 · Waiver
3545 W 86TH ST, INDIANAPOLIS, IN 46268(317) 228-0419(317) 228-0497 Get Directions Write a Review

NPPES record last updated: September 10, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 10, 2025, Nov 6, 2023, Jan 11, 2016 (3 updates tracked since 2016).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1487669511) is a healthcare organization registered as a pharmacy in Indianapolis, Indiana and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through August 16, 2026 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1487669511
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address3545 W 86TH STIndianapolis, IN 46268-1930
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Fax(317) 228-0497
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateJuly 29, 2006
Last NPPES UpdateSeptember 10, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2025
NPI 1487669511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in IN · 60004383A
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
3545 W 86TH ST, Indianapolis, IN 46268

Other Names 1

Other NameWalgreens # 11248

Other Identifiers 2

Other1530840Other Id Number-commercial Number
Medicaid100365790IN

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 15D2011466

Walgreens #11248 · Indianapolis, IN
Active · expires Aug 16, 2026
CLIA Number15D2011466
Laboratory TypePharmacy
Certificate Effective DateAugust 17, 2024
Certificate Expiration DateAugust 16, 2026
Laboratory DirectorGuhan Chari
Laboratory Phone(317) 228-0419
Laboratory LocationWalgreens #112483545 W 86th St, Indianapolis, IN 46268
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 2024 & 2026 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.
190 services190 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.
136 services136 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.
33 services33 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.
19 services19 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.
19 services19 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #11248 carries, from the Medicare DMEPOS supplier directory.

Walgreens #11248

DMEPOS supplier · Indianapolis, INOperated by Walgreen Co

Accepts Medicare assignment

Walgreens #11248 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)20361875
Medicare Participant SinceMarch 1, 2022
Supplier Location3545 W 86th StIndianapolis, IN 46268
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 11

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

Pharmacist
3545 W 86TH ST
INDIANAPOLIS, IN 46268
Pharmacist
3545 W 86TH ST
INDIANAPOLIS, IN 46268
Pharmacist
3545 W 86TH ST
INDIANAPOLIS, IN 46268
Pharmacist
3545 W 86TH ST
INDIANAPOLIS, IN 46268
Pharmacist
3545 W 86TH ST
INDIANAPOLIS, IN 46268
Pharmacist
3545 W 86TH ST
INDIANAPOLIS, IN 46268
Pharmacist
3545 W 86TH ST
INDIANAPOLIS, IN 46268
Nurse Practitioner (Family)
3545 W 86TH ST
INDIANAPOLIS, IN 46268

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1487669511, enumerated as an "organization" on July 29, 2006.

The provider is located at 3545 W 86TH ST INDIANAPOLIS, IN 46268 and the phone number is (317) 228-0419.

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.