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WALGREENS
NPI 1578831699
Pharmacy - Community/Retail Pharmacy in Provo, UT

Active since December 03, 2011CLIA 46D2011528 · Waiver
1315 N STATE ST, PROVO, UT 84604(801) 616-5223 Get Directions Write a Review

NPPES record last updated: December 3, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Walgreens NPPES

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

WALGREENS (NPI 1578831699) is a healthcare organization registered as a community/retail pharmacy in Provo, Utah and active in the NPI registry since December 2011. The organization holds a CLIA Waiver certificate valid through April 19, 2027 and lists Jeremy Lowell Hawkes, Pharmacy Manager, as its authorized official.

NPPES Registry Identity

NPI1578831699
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWALGREENS
Location Address1315 N STATE STProvo, UT 84604-2416
Mailing Address1315 N State StProvo, UT 84604-2416 · (801) 616-5223
Phone(801) 616-5223
Organization SubpartNo
Authorized OfficialJeremy Lowell HawkesPharmacy Manager · (801) 616-5223
Enumeration DateDecember 3, 2011
✔ NPI 1578831699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in UT · 6609157-1701
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
1315 N STATE ST, Provo, UT 84604
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Other Names 1

Other NameWalgreens

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 46D2011528

Walgreens #11734 · Provo, UT
Active · expires Apr 19, 2027
CLIA Number46D2011528
Laboratory TypePharmacy
Certificate Effective DateApril 20, 2025
Certificate Expiration DateApril 19, 2027
Laboratory DirectorLacey S. Bringhurst
Laboratory Phone(801) 616-5223
Laboratory LocationWalgreens #117341315 North State St, Provo, UT 84604
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

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

MR. NIEL KUHNER RPH
Pharmacist
1315 N STATE ST
PROVO, UT 84604
Utah County (801) 616-5223
JAMES C BAWDEN RPH
Pharmacist
1315 N STATE ST
PROVO, UT 84604
Utah County (801) 616-5223
MR. DANIEL BARNEY PHARMD
Pharmacist
1315 N STATE ST
PROVO, UT 84604
Utah County (801) 616-5223
DR. JEREMY LOWELL HAWKES PHARMD
Pharmacist
1315 N STATE ST
PROVO, UT 84604
Utah County (801) 616-5223
DR. CASEY JONATHAN GOBBLE PHARM.D.
Pharmacist
1315 N STATE ST
PROVO, UT 84604
Utah County (801) 616-5223
VINCENT JAMES HUTCHISON
Pharmacist
1315 N STATE ST
PROVO, UT 84604
Utah County (801) 616-5223
TEMBISA BURGESS
Pharmacy Technician
1315 N STATE ST
PROVO, UT 84604
Utah County (801) 616-5223
MICHAEL L STUMPE PHARMD
Pharmacist
1315 N STATE ST
PROVO, UT 84604
Utah County (801) 616-5223

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 Walgreens's NPI number?

The NPI number for Walgreens is 1578831699. It was assigned to this organization in the NPPES registry on December 3, 2011.

Where is Walgreens located?

Walgreens is located at 1315 N State St, Provo, UT 84604. The listed phone number is (801) 616-5223.

What is Walgreens's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Walgreens hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2011528) is associated with this NPI, valid through April 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Walgreens was last updated on December 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.