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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

WALGREEN CO
NPI 1700309739
Pharmacy in Holladay, UT

Active since July 21, 2017CLIA 46D2288334 · Waiver
4714 S HOLLADAY BLVD, HOLLADAY, UT 84117(801) 278-9767(801) 277-3473 Get Directions Write a Review

NPPES record last updated: July 22, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 22, 2026, May 9, 2022, Nov 2, 2018 and 2 more (5 updates tracked since 2017).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1700309739), doing business as Walgreens #17008, is a healthcare organization registered as a pharmacy in Holladay, Utah and active in the NPI registry since July 2017. The organization holds a CLIA Waiver certificate valid through August 23, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1700309739
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address4714 S HOLLADAY BLVDHolladay, UT 84117-5403
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Phone(801) 278-9767
Fax(801) 277-3473
Organization SubpartYesParent: Walgreens Holding Company
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateJuly 21, 2017
Last NPPES UpdateJuly 22, 20265 updates tracked since enumeration
NPPES CertifiedJuly 22, 2026
✔ NPI 1700309739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
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
4714 S HOLLADAY BLVD, Holladay, UT 84117
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Other Names 1

Doing Business AsWalgreens #17008

Other Identifiers 2

Other10604325-1703UT · Board Of Pharmacy
Medicaid3005282UT

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 46D2288334

Walgreens 17008 · Holladay, UT
Active · expires Aug 23, 2027
CLIA Number46D2288334
Laboratory TypePharmacy
Certificate Effective DateAugust 24, 2025
Certificate Expiration DateAugust 23, 2027
Laboratory DirectorDaniela Jotic
Laboratory Phone(801) 278-9767
Laboratory LocationWalgreens 170084714 Holladay Boulevard, Holladay, UT 84117
CLIA data matches this NPI record on: 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 Walgreens #17008 carries, from the Medicare DMEPOS supplier directory.

Walgreens #17008

DMEPOS supplier · Holladay, UTOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #17008 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)20381759
Medicare Participant SinceMarch 1, 2022
Supplier Location4714 S Holladay BlvdHolladay, UT 84117
Phone(801) 278-9767
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.

JOSEPH DRATTER PHARMD.
Pharmacist
4714 S HOLLADAY BLVD
HOLLADAY, UT 84117
Salt Lake County (801) 278-9767
CLAY DENISON
Pharmacist
4714 S HOLLADAY BLVD
HOLLADAY, UT 84117
Salt Lake County (801) 278-9767
ANDREW DENNIS BATTEEN PHARMD
Pharmacy (Community/Retail Pharmacy)
4714 S HOLLADAY BLVD
HOLLADAY, UT 84117
Salt Lake County (801) 278-9767
TATIANA GOOD PHARMD
Pharmacist
4714 S HOLLADAY BLVD
SALT LAKE CITY, UT 84117
Salt Lake County (801) 278-9841
WALGREEN CO
Pharmacy
4714 S HOLLADAY BLVD
HOLLADAY, UT 84117
Salt Lake County (217) 709-2386
DANIEL ROBBINS PHARM D
Pharmacist
4714 S HOLLADAY BLVD
HOLLADAY, UT 84117
Salt Lake County (801) 278-9767

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 1700309739. It was assigned to this organization in the NPPES registry on July 21, 2017. The provider is doing business as Walgreens #17008.

Where is Walgreen Co located?

Walgreen Co is located at 4714 S Holladay Blvd, Holladay, UT 84117. The listed phone number is (801) 278-9767.

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 #17008 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 46D2288334) is associated with this NPI, valid through August 23, 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 41 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 July 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days 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.