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WALGREEN CO.
NPI 1710733514
Pharmacy in Baltimore, MD

Active since April 24, 2024CLIA 21D2290555 · Waiver
1030 W 41ST ST STE E, BALTIMORE, MD 21211(410) 235-0002 Get Directions Write a Review

NPPES record last updated: April 24, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Walgreen Co. NPPES

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

WALGREEN CO. (NPI 1710733514), doing business as Walgreens #17205, is a healthcare organization registered as a pharmacy in Baltimore, Maryland and active in the NPI registry since April 2024. The organization holds a CLIA Waiver certificate valid through September 26, 2027 and lists Virginia Garza, Director - Ar Central, as its authorized official.

NPPES Registry Identity

NPI1710733514
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO.
Location Address1030 W 41ST ST STE EBaltimore, MD 21211-1662
Mailing Address1901 E Voorhees St # Ms 790Danville, IL 61834-4509 · (217) 709-2364 · Fax (217) 709-2344
Phone(410) 235-0002
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialVirginia GarzaDirector - Ar Central · (217) 709-2364
Enumeration DateApril 24, 2024
NPPES CertifiedApril 24, 2024
✔ NPI 1710733514 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
1030 W 41ST ST STE E, Baltimore, MD 21211
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Other Names 1

Doing Business AsWalgreens #17205

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 21D2290555

Walgreens #17205 · Baltimore, MD
Active · expires Sep 26, 2027
CLIA Number21D2290555
Laboratory TypePharmacy
Certificate Effective DateSeptember 27, 2025
Certificate Expiration DateSeptember 26, 2027
Laboratory DirectorDerek Etube
Laboratory Phone(410) 235-0002
Laboratory LocationWalgreens #172051030 West 41st Street Suite E, Baltimore, MD 21211
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

DEREK ETUBE PHARM.D
Pharmacist
1030 W 41ST ST STE E
BALTIMORE, MD 21211
Baltimore City (410) 235-0002
WALGREEN CO
Pharmacy
1030 W 41ST ST STE E
BALTIMORE, MD 21211
Baltimore City (410) 235-0002

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 1710733514. It was assigned to this organization in the NPPES registry on April 24, 2024. The provider is doing business as Walgreens #17205.

Where is Walgreen Co. located?

Walgreen Co. is located at 1030 W 41st St Ste E, Baltimore, MD 21211. The listed phone number is (410) 235-0002.

What is Walgreen Co.'s specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Walgreen Co. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2290555) is associated with this NPI, valid through September 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Walgreen Co. was last updated on April 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.