WALGREENS #10094
NPI 1629284260
Pharmacy - Community/Retail Pharmacy in Edmond, OK

Active since May 14, 2007CLIA 37D2008029 · Waiver
2675 N KELLY AVE, EDMOND, OK 73003(405) 844-0280(405) 844-0063 Get Directions Write a Review

NPPES record last updated: November 3, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 3, 2023, Mar 2, 2022, Aug 11, 2016 and 1 more (4 updates tracked since 2015).

About Walgreens #10094 NPPES

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

WALGREENS #10094 (NPI 1629284260) is a healthcare organization registered as a community/retail pharmacy in Edmond, Oklahoma and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through May 24, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1629284260
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWALGREEN CO
Location Address2675 N KELLY AVEEdmond, OK 73003-3337
Mailing Address1901 E Voorhees St, Ms #790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Fax(405) 844-0063
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateMay 14, 2007
Last NPPES UpdateNovember 3, 20234 updates tracked since enumeration
NPPES CertifiedNovember 3, 2023
NPI 1629284260 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in OK · 1-5175
Definition

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.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
2675 N KELLY AVE, Edmond, OK 73003

Other Names 1

Doing Business AsWalgreens #10094

Other Identifiers 3

Medicaid100245370Z DMEOK
Medicaid100245370XOK
Other100245370ZOK · 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 37D2008029

Walgreens #10094 · Edmond, OK
Active · expires May 24, 2027
CLIA Number37D2008029
Laboratory TypePharmacy
Certificate Effective DateMay 25, 2025
Certificate Expiration DateMay 24, 2027
Laboratory DirectorEmily Norman
Laboratory Phone(405) 844-0280
Laboratory LocationWalgreens #100942675 N Kelly Ave, Edmond, OK 73003
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 5

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.
336 services334 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.
222 services221 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.
105 services105 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
25 services25 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
24 services24 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20375435
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
2675 N KELLY AVE
EDMOND, OK 73003
Pharmacist
2675 N KELLY AVE
EDMOND, OK 73003
Pharmacist
2675 N KELLY AVE
EDMOND, OK 73003
Pharmacist
2675 N KELLY AVE
EDMOND, OK 73003
Pharmacist
2675 N KELLY AVE
EDMOND, OK 73003
Student in an Organized Health Care Education/Training Program
2675 N KELLY AVE
EDMOND, OK 73003

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629284260, enumerated as an "organization" on May 14, 2007.

The provider is located at 2675 N KELLY AVE EDMOND, OK 73003 and the phone number is (405) 844-0280.

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

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