WALGREENS #11433
NPI 1710200290
Pharmacy in Columbia, SC

Active since March 11, 2010CLIA 42D2021178 · Waiver
1941 BLOSSOM ST, COLUMBIA, SC 29205(803) 212-1015(803) 212-4695 Get Directions Write a Review

NPPES record last updated: November 2, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 2, 2023, Sep 2, 2016, Jun 24, 2016 and 1 more (4 updates tracked since 2016).

About Walgreens #11433 NPPES

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

WALGREENS #11433 (NPI 1710200290) is a healthcare organization registered as a pharmacy in Columbia, South Carolina and active in the NPI registry since March 2010. The organization holds a CLIA Waiver certificate valid through June 2, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1710200290
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address1941 BLOSSOM STColumbia, SC 29205-2217
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Fax(803) 212-4695
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateMarch 11, 2010
Last NPPES UpdateNovember 2, 20234 updates tracked since enumeration
NPPES CertifiedNovember 2, 2023
NPI 1710200290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in SC · 50-010870
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
1941 BLOSSOM ST, Columbia, SC 29205

Other Names 1

Doing Business AsWalgreens #11433

Other Identifiers 2

Other4229527SC · Ncpdp
Medicaid71576DSC

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 42D2021178

Walgreens #11433 · Columbia, SC
Active · expires Jun 2, 2027
CLIA Number42D2021178
Laboratory TypePharmacy
Certificate Effective DateJune 3, 2025
Certificate Expiration DateJune 2, 2027
Laboratory DirectorKristian A. Jensen
Laboratory Phone(803) 212-1015
Laboratory LocationWalgreens #114331941 Blossom St, Columbia, SC 29205
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 3

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.
58 services58 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.
40 services40 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.
17 services17 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #11433 carries, from the Medicare DMEPOS supplier directory.

Walgreens #11433

DMEPOS supplier · Columbia, SCOperated by Walgreen Co

Accepts Medicare assignment

Walgreens #11433 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)20378063
Medicare Participant SinceMarch 1, 2022
Supplier Location1941 Blossom StColumbia, SC 29205
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 12

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

Pharmacist
1941 BLOSSOM ST
COLUMBIA, SC 29205
Pharmacist
1941 BLOSSOM ST
COLUMBIA, SC 29205
Pharmacist
1941 BLOSSOM ST
COLUMBIA, SC 29205
Pharmacist
1941 BLOSSOM ST
COLUMBIA, SC 29205
Pharmacist
1941 BLOSSOM ST
COLUMBIA, SC 29205
Pharmacist
1941 BLOSSOM ST
COLUMBIA, SC 29205
Pharmacist
1941 BLOSSOM ST
COLUMBIA, SC 29205
Pharmacist
1941 BLOSSOM ST
COLUMBIA, SC 29205

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1710200290, enumerated as an "organization" on March 11, 2010.

The provider is located at 1941 BLOSSOM ST COLUMBIA, SC 29205 and the phone number is (803) 212-1015.

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.