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WALGREEN CO
NPI 1598770638
Pharmacy in Fort Wayne, IN

Active since July 29, 2006CLIA 15D2037743 · Waiver
110 E CREIGHTON AVE, FORT WAYNE, IN 46803(260) 456-1841 Get Directions Write a Review

NPPES record last updated: September 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 8, 2025, Nov 3, 2023, Mar 11, 2022 (3 updates tracked since 2022).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1598770638), doing business as Walgreens #03722, is a healthcare organization registered as a pharmacy in Fort Wayne, Indiana and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through September 20, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1598770638
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address110 E CREIGHTON AVEFort Wayne, IN 46803-3344
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Phone(260) 456-1841
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateJuly 29, 2006
Last NPPES UpdateSeptember 8, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 8, 2025
✔ NPI 1598770638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in IN · 60003073
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
110 E CREIGHTON AVE, Fort Wayne, IN 46803
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Other Names 1

Doing Business AsWalgreens #03722

Other Identifiers 2

Other1532666Other Id Number-commercial Number
Medicaid100307690AIN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.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 15D2037743

Walgreens #03722 · Fort Wayne, IN
Active · expires Sep 20, 2027
CLIA Number15D2037743
Laboratory TypePharmacy
Certificate Effective DateSeptember 21, 2025
Certificate Expiration DateSeptember 20, 2027
Laboratory DirectorCourtney T. Smith
Laboratory Phone(260) 456-1841
Laboratory LocationWalgreens #03722110 E Creighton Ave, Fort Wayne, IN 46803
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.
30 services30 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.
20 services20 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #3722 carries, from the Medicare DMEPOS supplier directory.

Walgreens #3722

DMEPOS supplier · Fort Wayne, INOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #3722 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)20352821
Medicare Participant SinceMarch 1, 2022
Supplier Location110 E Creighton AveFort Wayne, IN 46803
Phone(260) 456-1841
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 3

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

EHLIMANA HAMIDOVIC
Pharmacist
110 E CREIGHTON AVE
FORT WAYNE, IN 46803
Allen County (260) 456-1841
DR. MARIAH VASQUEZ PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
110 E CREIGHTON AVE
FORT WAYNE, IN 46803
Allen County (260) 456-1841
MR. PATRICK DEWAYNE SHANNON
Pharmacist
110 E CREIGHTON AVE
FORT WAYNE, IN 46803
Allen County (260) 456-1841

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 1598770638. It was assigned to this organization in the NPPES registry on July 29, 2006. The provider is doing business as Walgreens #03722.

Where is Walgreen Co located?

Walgreen Co is located at 110 E Creighton Ave, Fort Wayne, IN 46803. The listed phone number is (260) 456-1841.

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 #3722 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 15D2037743) is associated with this NPI, valid through September 20, 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 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 September 8, 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.