WALGREENS
NPI 1639582604
Clinic/Center - Community Health in Saint Louis, MO

Active since June 08, 2014CLIA 26D1060570 · Waiver
4218 LINDELL BLVD, SAINT LOUIS, MO 63108(314) 371-4286 Get Directions Write a Review

NPPES record last updated: June 8, 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 1639582604) is a healthcare organization registered as a community health in Saint Louis, Missouri and active in the NPI registry since June 2014. The organization holds a CLIA Waiver certificate valid through October 25, 2026 and lists Kellye Holtgrave, Supervisor, as its authorized official.

NPPES Registry Identity

NPI1639582604
Entity TypeOrganization
Primary Taxonomy261QC1500X
Legal Business NameWALGREENS
Location Address4218 LINDELL BLVDSaint Louis, MO 63108-2916
Mailing Address600 Thiebes RdLabadie, MO 63055-1710 · (636) 751-5778
Organization SubpartNo
Authorized OfficialKellye HoltgraveSupervisor · (314) 739-4503
Enumeration DateJune 8, 2014
NPI 1639582604 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities
Taxonomy Code261QC1500X
License Licensed in MO · 2013026259
4218 LINDELL BLVD, Saint Louis, MO 63108

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 26D1060570

Walgreens #06472 · Saint Louis, MO
Active · expires Oct 25, 2026
CLIA Number26D1060570
Laboratory TypePharmacy
Certificate Effective DateOctober 26, 2024
Certificate Expiration DateOctober 25, 2026
Laboratory DirectorTheresa D. Deterding
Laboratory Phone(314) 371-4286
Laboratory LocationWalgreens #064724218 Lindell Blvd, Saint Louis, MO 63108
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 Walgreen Co carries, from the Medicare DMEPOS supplier directory.

Walgreen Co

DMEPOS supplier · Saint Louis, MO

Accepts Medicare assignment

Walgreen Co 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)20359787
Medicare Participant SinceMarch 1, 2022
Supplier Location4218 Lindell BlvdSaint Louis, MO 63108
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 20

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

Pharmacist
4218 LINDELL BLVD
SAINT LOUIS, MO 63108
Pharmacist
4218 LINDELL BLVD
SAINT LOUIS, MO 63108
Pharmacist
4218 LINDELL BLVD
SAINT LOUIS, MO 63108
Pharmacist
4218 LINDELL BLVD
SAINT LOUIS, MO 63108
Pharmacist
4218 LINDELL BLVD
SAINT LOUIS, MO 63108
Pharmacist
4218 LINDELL BLVD
SAINT LOUIS, MO 63108
Pharmacist
4218 LINDELL BLVD
SAINT LOUIS, MO 63108
Pharmacist
4218 LINDELL BLVD
SAINT LOUIS, MO 63108

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 1639582604. It was assigned to this organization in the NPPES registry on June 8, 2014.

Where is Walgreens located?

Walgreens is located at 4218 Lindell Blvd, Saint Louis, MO 63108. The listed phone number is (314) 371-4286.

What is Walgreens's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

Does Walgreens accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Walgreen Co 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 26D1060570) is associated with this NPI, valid through October 25, 2026. 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 June 8, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.