WALGREEN CO
NPI 1578795159
Pharmacy in Lake Stevens, WA

Active since August 17, 2009CLIA 50D2036556 · Waiver
718 91ST AVE NE, LAKE STEVENS, WA 98258(425) 334-1523(425) 334-1858 Get Directions Write a Review

NPPES record last updated: August 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 7, 2025, Apr 8, 2022, May 10, 2018 and 1 more (4 updates tracked since 2016).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1578795159), doing business as Walgreens #12933, is a healthcare organization registered as a pharmacy in Lake Stevens, Washington and active in the NPI registry since August 2009. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1578795159
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address718 91ST AVE NELake Stevens, WA 98258-2420
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Fax(425) 334-1858
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateAugust 17, 2009
Last NPPES UpdateAugust 7, 20254 updates tracked since enumeration
NPPES CertifiedAugust 7, 2025
NPI 1578795159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in WA · CF60114388
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
718 91ST AVE NE, Lake Stevens, WA 98258

Other Names 1

Doing Business AsWalgreens #12933

Other Identifiers 2

Medicaid1578795159WA
Other4933467Ncpdp

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 50D2036556

Walgreens # 12933 · Lake Stevens, WA
Active · expires Apr 4, 2028
CLIA Number50D2036556
Laboratory TypePharmacy
Certificate Effective DateDecember 18, 2020
Certificate Expiration DateApril 4, 2028
Laboratory DirectorAnna Phung
Laboratory Phone(425) 334-1523
Laboratory LocationWalgreens # 12933718 91st Ave NE, Lake Stevens, WA 98258
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 2

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.
67 services67 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.
50 services50 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #12933 carries, from the Medicare DMEPOS supplier directory.

Walgreens #12933

DMEPOS supplier · Lake Stevens, WAOperated by Walgreen Co

Accepts Medicare assignment

Walgreens #12933 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)20376539
Medicare Participant SinceMarch 1, 2022
Supplier Location718 91st Ave NELake Stevens, WA 98258
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 4

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

Pharmacist
718 91ST AVE NE
LAKE STEVENS, WA 98258
Nurse Practitioner (Family)
718 91ST AVE NE
LAKE STEVENS, WA 98258
Pharmacist
718 91ST AVE NE
LAKE STEVENS, WA 98258
Pharmacist
718 91ST AVE NE
LAKE STEVENS, WA 98258

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 1578795159. It was assigned to this organization in the NPPES registry on August 17, 2009. The provider is doing business as Walgreens #12933.

Where is Walgreen Co located?

Walgreen Co is located at 718 91st Ave NE, Lake Stevens, WA 98258. The listed phone number is (425) 334-1523.

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 #12933 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 50D2036556) is associated with this NPI, valid through April 4, 2028. 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 40 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 August 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.