WALGREENS #12714
NPI 1598909772
Pharmacy in Catoosa, OK

Active since May 01, 2009CLIA 37D2022854 · Waiver
315 N 193RD EAST AVE, CATOOSA, OK 74015(918) 266-8837(918) 266-1512 Get Directions Write a Review

NPPES record last updated: April 5, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 5, 2022, Aug 11, 2016, Nov 23, 2015 (3 updates tracked since 2015).

About Walgreens #12714 NPPES

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

WALGREENS #12714 (NPI 1598909772) is a healthcare organization registered as a pharmacy in Catoosa, Oklahoma and active in the NPI registry since May 2009. The organization holds a CLIA Waiver certificate valid through March 22, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1598909772
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address315 N 193RD EAST AVECatoosa, OK 74015-2862
Mailing Address1901 E Voorhees St, Ms #790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Fax(918) 266-1512
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateMay 1, 2009
Last NPPES UpdateApril 5, 20223 updates tracked since enumeration
NPPES CertifiedApril 5, 2022
NPI 1598909772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in OK · 29-5443
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
315 N 193RD EAST AVE, Catoosa, OK 74015

Other Names 1

Doing Business AsWalgreens #12714

Other Identifiers 3

Medicaid100242740QOK
Other3725706Ncpdp
Other100242740ROK · Medicaid Dme

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 37D2022854

Walgreens # 12714 · Catoosa, OK
Active · expires Mar 22, 2027
CLIA Number37D2022854
Laboratory TypePharmacy
Certificate Effective DateMarch 23, 2025
Certificate Expiration DateMarch 22, 2027
Laboratory DirectorDylan Hancin
Laboratory Phone(918) 266-8837
Laboratory LocationWalgreens # 12714315 N 193rd East Avenue, Catoosa, OK 74015
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 3

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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.
77 services77 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.
41 services41 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
33 services33 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20386217
Accepts Medicare Assignment
YES
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • 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
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

Other Providers at the Same Location NPPES 6

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

Pharmacist
315 N 193RD EAST AVE
CATOOSA, OK 74015
Pharmacist
315 N 193RD EAST AVE
CATOOSA, OK 74015
Pharmacist
315 N 193RD EAST AVE
CATOOSA, OK 74015
Pharmacist
315 N 193RD EAST AVE
CATOOSA, OK 74015
Pharmacist
315 N 193RD EAST AVE
CATOOSA, OK 74015
Pharmacist
315 N 193RD EAST AVE
CATOOSA, OK 74015

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1598909772, enumerated as an "organization" on May 01, 2009.

The provider is located at 315 N 193RD EAST AVE CATOOSA, OK 74015 and the phone number is (918) 266-8837.

Pharmacy with taxonomy code 333600000X.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.