1. Home
  2. Directory
  3. Michigan
  4. Dearborn
  5. Pharmacy
  6. NPI Profile

WALGREEN CO
NPI 1619984606
Pharmacy in Dearborn, MI

Active since August 02, 2006CLIA 23D2046495 · Waiver
13601 W WARREN AVE, DEARBORN, MI 48126(313) 624-9530 Get Directions Write a Review

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

Record update history: Jun 3, 2026, Apr 22, 2022, Nov 24, 2015 (3 updates tracked since 2015).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1619984606), doing business as Walgreens #05032, is a healthcare organization registered as a pharmacy in Dearborn, Michigan and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through March 29, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1619984606
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address13601 W WARREN AVEDearborn, MI 48126-1420
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Phone(313) 624-9530
Organization SubpartYesParent: Walgreens Holding Company
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateAugust 2, 2006
Last NPPES UpdateJune 3, 20263 updates tracked since enumeration
NPPES CertifiedJune 3, 2026
✔ NPI 1619984606 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in MI · 5301007071
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
13601 W WARREN AVE, Dearborn, MI 48126
Open in Google Maps ↗

Other Names 1

Doing Business AsWalgreens #05032

Other Identifiers 3

Medicaid4139250MI
Medicaid4808477 DMEMI
Other2360395Other Id Number-commercial Number

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 23D2046495

Walgreens #05032 · Dearborn, MI
Active · expires Mar 29, 2027
CLIA Number23D2046495
Laboratory TypePharmacy
Certificate Effective DateMarch 30, 2025
Certificate Expiration DateMarch 29, 2027
Laboratory DirectorSaraha S. Al Hajaj
Laboratory Phone(313) 624-9530
Laboratory LocationWalgreens #0503213601 W Warren Ave, Dearborn, MI 48126
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.
22 services22 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.
11 services11 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #5032 carries, from the Medicare DMEPOS supplier directory.

Walgreens #5032

DMEPOS supplier · Dearborn, MIOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #5032 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)20391107
Medicare Participant SinceMarch 1, 2022
Supplier Location13601 W Warren AveDearborn, MI 48126
Phone(313) 624-9530
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 6

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

ROA ALDHALEMI PHARMD
Pharmacist
13601 W WARREN AVE
DEARBORN, MI 48126
Wayne County (313) 624-9530
HASSAN SHUKR RPH
Pharmacist
13601 W WARREN AVE
DEARBORN, MI 48126
Wayne County (313) 624-9530
ABIR SHUKR RPH
Pharmacist
13601 W WARREN AVE
DEARBORN, MI 48126
Wayne County (313) 624-9530
SAFA KANAN
Pharmacist
13601 W WARREN AVE
DEARBORN, MI 48126
Wayne County (313) 624-9530
YASMEEN MUSTAPHA
Pharmacist
13601 W WARREN AVE
DEARBORN, MI 48126
Wayne County (313) 624-9530
AHMED OBAD AHMED
Pharmacist
13601 W WARREN AVE
DEARBORN, MI 48126
Wayne County (313) 624-9530

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 1619984606. It was assigned to this organization in the NPPES registry on August 2, 2006. The provider is doing business as Walgreens #05032.

Where is Walgreen Co located?

Walgreen Co is located at 13601 W Warren Ave, Dearborn, MI 48126. The listed phone number is (313) 624-9530.

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 #5032 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 23D2046495) is associated with this NPI, valid through March 29, 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 42 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 June 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.