WALGREEN CO
NPI 1487669560
Pharmacy in East Patchogue, NY

Active since July 29, 2006CLIA 33D2226664 · Waiver
655 E MAIN ST, EAST PATCHOGUE, NY 11772(631) 447-6282 Get Directions Write a Review

NPPES record last updated: June 16, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 8, 2025, Apr 12, 2022, Jan 25, 2019 (3 updates tracked since 2019).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1487669560), doing business as Walgreens #13643, is a healthcare organization registered as a pharmacy in East Patchogue, New York and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1487669560
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address655 E MAIN STEast Patchogue, NY 11772-3152
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Organization SubpartYesParent: Walgreens Holding Company
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateJuly 29, 2006
Last NPPES UpdateJune 16, 20263 updates tracked since enumeration
NPPES CertifiedJune 16, 2026
NPI 1487669560 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in NY · 20611
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
655 E MAIN ST, East Patchogue, NY 11772

Other Names 1

Doing Business AsWalgreens #13643

Other Identifiers 2

Other3396202Other Id Number-commercial Number
Medicaid01196730NY

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 33D2226664

Walgreens No 13643 · East Patchogue, NY
Active · expires Mar 26, 2027
CLIA Number33D2226664
Laboratory TypePharmacy
Certificate Effective DateJune 2, 2021
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Zeiad Fakhouri
Laboratory Phone(631) 447-6282
Laboratory LocationWalgreens No 13643655 E Main St, East Patchogue, NY 11772
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 Walgreens #13643 carries, from the Medicare DMEPOS supplier directory.

Walgreens #13643

DMEPOS supplier · East Patchogue, NYOperated by Walgreen Co

Accepts Medicare assignment

Walgreens #13643 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)20385803
Medicare Participant SinceMarch 1, 2022
Supplier Location655 E Main StEast Patchogue, NY 11772
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

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

Pharmacist
655 E MAIN ST
EAST PATCHOGUE, NY 11772

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 1487669560. It was assigned to this organization in the NPPES registry on July 29, 2006. The provider is doing business as Walgreens #13643.

Where is Walgreen Co located?

Walgreen Co is located at 655 E Main St, East Patchogue, NY 11772. The listed phone number is (631) 447-6282.

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 #13643 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 33D2226664) is associated with this NPI, valid through March 26, 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 39 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 June 16, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.