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WALGREENS #17195
NPI 1508383472
Pharmacy in Dryden, NY

Active since August 23, 2017CLIA 33D2237094 · Waiver
79 NORTH ST, DRYDEN, NY 13053(607) 844-3151(607) 844-3043 Get Directions Write a Review

NPPES record last updated: May 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 11, 2022, Jul 30, 2018, Jun 15, 2018 and 1 more (4 updates tracked since 2017).

About Walgreens #17195 NPPES

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

WALGREENS #17195 (NPI 1508383472) is a healthcare organization registered as a pharmacy in Dryden, New York and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1508383472
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address79 NORTH STDryden, NY 13053-8510
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Phone(607) 844-3151
Fax(607) 844-3043
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateAugust 23, 2017
Last NPPES UpdateMay 11, 20224 updates tracked since enumeration
NPPES CertifiedMay 11, 2022
✔ NPI 1508383472 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in NY · 036254
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
79 NORTH ST, Dryden, NY 13053
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Other Names 1

Doing Business AsWalgreens #17195

Other Identifiers 2

Medicaid05075943NY
Other5822944NY · Ncpdp

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Humana, Medica, Moda Health Plan, Inc..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 33D2237094

Walgreens No 17195 · Dryden, NY
Active · expires Mar 26, 2027
CLIA Number33D2237094
Laboratory TypePharmacy
Certificate Effective DateSeptember 22, 2021
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Zeiad A. Fakhouri
Laboratory Phone(607) 844-3404
Laboratory LocationWalgreens No 1719579 North St, Dryden, NY 13053
CLIA data matches this NPI record on: Address Name
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 Walgreen Co carries, from the Medicare DMEPOS supplier directory.

Walgreen Co

DMEPOS supplier · Dryden, NY
✔

Accepts Medicare assignment

Walgreen Co 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)20377403
Medicare Participant SinceMarch 1, 2022
Supplier Location79 North StDryden, NY 13053
Phone(607) 844-3404
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 2

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

SAMANTHA JANE CLARK PHARM.D.
Pharmacist
79 NORTH ST
DRYDEN, NY 13053
Tompkins County (607) 844-3404
CHRISTINE Y DOW RPH
Pharmacist
79 NORTH ST
DRYDEN, NY 13053
Tompkins County (607) 844-3404

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 1508383472. It was assigned to this organization in the NPPES registry on August 23, 2017. The provider is doing business as Walgreens #17195.

Where is Walgreen Co located?

Walgreen Co is located at 79 North St, Dryden, NY 13053. The listed phone number is (607) 844-3151.

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, Walgreen Co 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 33D2237094) 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 Humana, Medica and Moda Health Plan, Inc. 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 May 11, 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.