WALGREENS #04847
NPI 1700891942
Pharmacy in Lynn Haven, FL

Active since July 29, 2006CLIA 10D2012412 · Waiver
1402 OHIO AVE, LYNN HAVEN, FL 32444(850) 265-0499 Get Directions Write a Review

NPPES record last updated: April 20, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 20, 2022, May 7, 2018, Nov 13, 2015 (3 updates tracked since 2015).

About Walgreens #04847 NPPES

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

WALGREENS #04847 (NPI 1700891942) is a healthcare organization registered as a pharmacy in Lynn Haven, Florida and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through July 6, 2027 and lists Kira L Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1700891942
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address1402 OHIO AVELynn Haven, FL 32444-3743
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira L TaylorManager · (217) 709-2351
Enumeration DateJuly 29, 2006
Last NPPES UpdateApril 20, 20223 updates tracked since enumeration
NPPES CertifiedApril 20, 2022
NPI 1700891942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in FL · PH0016371
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
1402 OHIO AVE, Lynn Haven, FL 32444

Other Names 1

Doing Business AsWalgreens #04847

Other Identifiers 3

Medicaid106587400FL
Other1085097Other Id Number-commercial Number
Medicaid106587401 DMEFL

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 10D2012412

Walgreens Co · Lynn Haven, FL
Active · expires Jul 6, 2027
CLIA Number10D2012412
Laboratory TypePharmacy
Certificate Effective DateJuly 7, 2025
Certificate Expiration DateJuly 6, 2027
Laboratory DirectorAshlei D. Yates
Laboratory Phone(850) 265-0499
Laboratory LocationWalgreens Co1402 Ohio Ave, Lynn Haven, FL 32444
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.
108 services108 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.
50 services50 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.
35 services35 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.
12 services12 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.
12 services12 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20392559
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 12

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

Pharmacist
1402 OHIO AVE
LYNN HAVEN, FL 32444
Pharmacist
1402 OHIO AVE
LYNN HAVEN, FL 32444
Pharmacist
1402 OHIO AVE
LYNN HAVEN, FL 32444
Pharmacist (Pharmacotherapy)
1402 OHIO AVE
LYNN HAVEN, FL 32444
Pharmacist
1402 OHIO AVE
LYNN HAVEN, FL 32444
Pharmacist
1402 OHIO AVE
LYNN HAVEN, FL 32444
Pharmacist
1402 OHIO AVE
LYNN HAVEN, FL 32444
Pharmacist
1402 OHIO AVE
LYNN HAVEN, FL 32444

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1700891942, enumerated as an "organization" on July 29, 2006.

The provider is located at 1402 OHIO AVE LYNN HAVEN, FL 32444 and the phone number is (850) 265-0499.

Pharmacy with taxonomy code 333600000X.

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