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WALGREENS
NPI 1619374139
Pharmacist in San Jose, CA

Active since November 26, 2014CLIA 05D2295736 · Waiver
1376 KOOSER RD, SAN JOSE, CA 95118(408) 448-2503 Get Directions Write a Review

NPPES record last updated: November 26, 2014. 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 1619374139) is a healthcare organization registered as a pharmacist in San Jose, California and active in the NPI registry since November 2014. The organization holds a CLIA Waiver certificate valid through December 14, 2027 and lists Andy Davenport, District Pharmacy Supervisor, as its authorized official.

NPPES Registry Identity

NPI1619374139
Entity TypeOrganization
Primary Taxonomy183500000X
Legal Business NameWALGREENS
Location Address1376 KOOSER RDSan Jose, CA 95118-3813
Mailing Address535 S Market St, Apartment 306San Jose, CA 95113-2841 · (314) 922-7141
Phone(408) 448-2503
Organization SubpartNo
Authorized OfficialAndy DavenportDistrict Pharmacy Supervisor · (650) 348-1559
Enumeration DateNovember 26, 2014
✔ NPI 1619374139 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
1376 KOOSER RD, San Jose, CA 95118
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 05D2295736

Walgreens 03378 · San Jose, CA
Active · expires Dec 14, 2027
CLIA Number05D2295736
Laboratory TypePharmacy
Certificate Effective DateDecember 15, 2025
Certificate Expiration DateDecember 14, 2027
Laboratory DirectorDalia Ahmed
Laboratory Phone(408) 448-2503
Laboratory LocationWalgreens 033781376 Kooser Rd, San Jose, CA 95118
CLIA data matches this NPI record on: Address Name Phone
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 Walgreens #03378 carries, from the Medicare DMEPOS supplier directory.

Walgreens #03378

DMEPOS supplier · San Jose, CAOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #03378 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)20352479
Medicare Participant SinceMarch 1, 2022
Supplier Location1376 Kooser RdSan Jose, CA 95118
Phone(408) 448-2503
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 7

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

SUJATHA CHALUVADI
Pharmacist
1376 KOOSER RD
SAN JOSE, CA 95118
Santa Clara County (408) 448-2503
ANNE HOFFMAN
Pharmacist
1376 KOOSER RD
SAN JOSE, CA 95118
Santa Clara County (314) 922-7141
BETTY GIA TRINH RPH
Pharmacist
1376 KOOSER RD
SAN JOSE, CA 95118
Santa Clara County (408) 448-2503
HOWARD MINH-LUAN LAM
Pharmacist
1376 KOOSER RD
SAN JOSE, CA 95118
Santa Clara County (408) 448-2503
MARIAM ELAIWA RPH
Pharmacist
1376 KOOSER RD
SAN JOSE, CA 95118
Santa Clara County (408) 448-2503
WALGREEN CO
Pharmacy
1376 KOOSER RD
SAN JOSE, CA 95118
Santa Clara County (408) 448-2503
CHRISTINE THANH NGUYEN PHARM. D
Pharmacist
1376 KOOSER RD
SAN JOSE, CA 95118
Santa Clara County (408) 448-2503

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 1619374139. It was assigned to this organization in the NPPES registry on November 26, 2014.

Where is Walgreens located?

Walgreens is located at 1376 Kooser Rd, San Jose, CA 95118. The listed phone number is (408) 448-2503.

What is Walgreens's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

Does Walgreens accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Walgreens #03378 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Walgreens hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2295736) is associated with this NPI, valid through December 14, 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 November 26, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.