WALGREENS #15778
NPI 1629152772
Pharmacy - Community/Retail Pharmacy in Tulsa, OK

Active since October 25, 2006
6336 E 4TH PL, TULSA, OK 74112(918) 833-5180(918) 835-2993 Get Directions Write a Review

NPPES record last updated: December 27, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 27, 2016, Nov 24, 2015 (2 updates tracked since 2015).

  • Organization
  • Pharmacy
  • Community/Retail Pharmacy
  • Accepts Insurance

About WALGREENS #15778

This page provides the complete NPI Profile along with additional information for Walgreens #15778, a provider established in Tulsa, Oklahoma operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1629152772 assigned on October 2006. The practitioner's primary taxonomy code is 3336C0003X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's is doing business as Walgreens #15778. The authorized official of this NPI record is Mr. Alan T. Nielsen (Treasurer)

NPI
1629152772 Verify this NPI
Provider Legal Name
WALGREEN CO
Other Organization Name
WALGREENS #15778
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
6336 E 4TH PL TULSA, OK 74112
Location Phone
(918) 833-5180
Location Fax
(918) 835-2993
Mailing Address
1901 E VOORHEES ST MS 790 DANVILLE, IL 61834
Mailing Phone
(217) 709-2386
Mailing Fax
(217) 709-2344
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
10-25-2006
Last Update Date
12-27-2016
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy Community/Retail Pharmacy

Taxonomy Code
3336C0003X
Type
Suppliers
Taxonomy Description
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1332B00000XSuppliers

Durable Medical Equipment & Medical Supplies

24344 (OK)
2333600000XSuppliers

Pharmacy

24344 (OK)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Select by Medica Bronze $0 Copay PCP Visits - EPO
  • Select by Medica Bronze Share - EPO
  • Select by Medica Expanded Bronze Standard - EPO
  • Select by Medica Gold $0 Copay PCP Visits - EPO
  • Select by Medica Gold Share - EPO
  • Select by Medica Gold Standard - EPO
  • Select by Medica Silver $0 Copay PCP Visits - EPO
  • Select by Medica Silver Share - EPO
  • Select by Medica Silver Standard - EPO
  • Moda Health Affinity Bronze 8000 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO
  • Moda Health Oregon Standard Bronze Affinity - EPO
  • Moda Health Oregon Standard Gold Affinity - EPO
  • Moda Health Oregon Standard Silver Affinity - EPO
  • Moda Select Alaska Bronze 6500 - PPO
  • Moda Select Alaska Bronze HDHP 5500 - PPO
  • Moda Select Alaska Gold 1500 - PPO
  • Moda Select Alaska Silver 4500 - PPO
  • Moda Select Alaska Standard Bronze - PPO
  • Moda Select Alaska Standard Gold - PPO
  • Moda Select Alaska Standard Silver - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. ALAN T. NIELSEN

Authorized Official Title
TREASURER
Authorized Official Phone
(847) 315-3523

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
3721962OTHER (01)OTHER ID NUMBER-COMMERCIAL NUMBER
0448880040MEDICARE NSC (07)OK 
0282938406MEDICARE NSC (07) 
400522489OTHER (01)OKMEDICARE FLU
200077890DOTHER (01)OKMEDICAID DME
100241490SMEDICAID (05)OK 

Reviews for WALGREENS #15778

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Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Pharmacist
6336 E 4TH PL
TULSA, OK 74112
Pharmacist
6336 E 4TH PL
TULSA, OK 74112
Pharmacist
6336 E 4TH PL
TULSA, OK 74112

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629152772, enumerated as an "organization" on October 25, 2006.

The provider is located at 6336 E 4TH PL TULSA, OK 74112 and the phone number is (918) 833-5180.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Medica, Moda Health Plan, Inc., Medicare and. Please consult your insurance carrier or call the provider to verify.