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WALGREENS #17795
NPI 1619491297
Pharmacy in Blackshear, GA

Active since July 26, 2017CLIA 11D2291046 · Waiver
3537 US HIGHWAY 84, BLACKSHEAR, GA 31516(912) 449-0811(912) 449-8288 Get Directions Write a Review

NPPES record last updated: May 16, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 16, 2022, Apr 29, 2019, Apr 27, 2018 and 1 more (4 updates tracked since 2017).

About Walgreens #17795 NPPES

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

WALGREENS #17795 (NPI 1619491297) is a healthcare organization registered as a pharmacy in Blackshear, Georgia and active in the NPI registry since July 2017. The organization holds a CLIA Waiver certificate valid through October 3, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1619491297
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address3537 US HIGHWAY 84Blackshear, GA 31516-2237
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Phone(912) 449-0811
Fax(912) 449-8288
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateJuly 26, 2017
Last NPPES UpdateMay 16, 20224 updates tracked since enumeration
NPPES CertifiedMay 16, 2022
✔ NPI 1619491297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in GA · PHRE010481
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
3537 US HIGHWAY 84, Blackshear, GA 31516
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Other Names 1

Doing Business AsWalgreens #17795

Other Identifiers 2

Medicaid000718946AGA
Other1170430GA · Ncpdp

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 11D2291046

Walgreens #17795 · Blackshear, GA
Active · expires Oct 3, 2027
CLIA Number11D2291046
Laboratory TypePharmacy
Certificate Effective DateOctober 4, 2025
Certificate Expiration DateOctober 3, 2027
Laboratory DirectorBrittany Lowder
Laboratory Phone(912) 449-0811
Laboratory LocationWalgreens #177953537 Us Highway 84, Blackshear, GA 31516
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 #17795 carries, from the Medicare DMEPOS supplier directory.

Walgreens #17795

DMEPOS supplier · Blackshear, GAOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #17795 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)20380223
Medicare Participant SinceMarch 1, 2022
Supplier Location3537 Us Highway 84Blackshear, GA 31516
Phone(912) 449-0811
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 5

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

GAGANDEEP KAUR ATWAL PHARMD
Pharmacist
3537 US HIGHWAY 84
BLACKSHEAR, GA 31516
Pierce County (912) 449-0811
DAVID LAWRENCE MADRAY IV PHARM.D.
Pharmacist
3537 US HIGHWAY 84
BLACKSHEAR, GA 31516
Pierce County (912) 449-0811
MATTHEW SHIMKUS
Pharmacist
3537 US HIGHWAY 84
BLACKSHEAR, GA 31516
Pierce County (912) 449-0811
MARY JOHNSON PHARMD
Pharmacist
3537 US HIGHWAY 84
BLACKSHEAR, GA 31516
Pierce County (912) 449-0811
YOO BIN JIN
Pharmacist
3537 US HIGHWAY 84
BLACKSHEAR, GA 31516
Pierce County (912) 449-0811

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 1619491297. It was assigned to this organization in the NPPES registry on July 26, 2017. The provider is doing business as Walgreens #17795.

Where is Walgreen Co located?

Walgreen Co is located at 3537 Us Highway 84, Blackshear, GA 31516. The listed phone number is (912) 449-0811.

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 #17795 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 11D2291046) is associated with this NPI, valid through October 3, 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 39 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 May 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.