WALGREENS
NPI 1699058644
Pharmacy in Marion, IL

NPI Status: Active since September 26, 2011

Contact Information

1710 W DEYOUNG ST
MARION, IL
ZIP 62959
Phone: (618) 998-1603

NPI Profile Information
Primary Taxonomy
Authorized Official
Medical Equipment Supplier
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Pharmacy
Medicare Supplier
Accepts Medicare Approved Payment
CLIA Number: 14D2037879
CLIA Cert. Type: Pharmacy
CLIA Exp. Date: 03-21-2027

About WALGREENS

This page provides the complete NPI Profile along with additional information for Walgreens, a provider established in Marion, Illinois operating as a Pharmacy. The healthcare provider is registered in the NPI registry with number 1699058644 assigned on September 2011. The practitioner's primary taxonomy code is 333600000X with license number 1831104041 (IL). The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Hilary D Brown Pharmd (Pharmacy Manager)

NPI: 1699058644
Provider Name: WALGREENS
Entity Type: Organization
Location Address: 1710 W DEYOUNG ST MARION, IL 62959
Location Phone: (618) 998-1603
Mailing Address: 1710 W DEYOUNG ST MARION, IL 62959
Mailing Phone: (618) 998-1603
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 09-26-2011
Last Update Date: 09-26-2011
Code Navigator

Walgreens is a medicare supplier with PTAN 20365619 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Infusion Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Blood Glucose Monitors/Supplies (Non-Mail Order).

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
Taxonomy Code: 333600000X
Type: Suppliers
License No.: 1831104041
License State: IL
Taxonomy Description: 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.

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: HILARY D BROWN PHARMD
Authorized Official Title: PHARMACY MANAGER
Authorized Official Phone: (618) 998-1603

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN: 20365619
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

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 14D2037879
Facility Type: Pharmacy
Certificate Effective Date: March 22, 2025
Certificate Expiration Date: March 21, 2027
Laboratory Director: AMBER K. KROTZ
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Walgreens to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	6	9	9	0	5	8	6	4	4
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	6	18	9	0	5	16	6	8
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 1 + 8 + 9 + 0 + 5 + 1 + 6 + 6 + 8 + 24 = 76
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 76 = 4									4

The NPI number 1699058644 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.