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WALGREEN CO
NPI 1710993118
Pharmacy in Farmington, NM

Active since July 31, 2006CLIA 32D2223411 · Waiver
4221 E MAIN ST, FARMINGTON, NM 87402(505) 325-1749 Get Directions Write a Review

NPPES record last updated: March 27, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 27, 2026, Apr 5, 2022, Oct 24, 2021 and 1 more (4 updates tracked since 2016).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1710993118), doing business as Walgreens #04510, is a healthcare organization registered as a pharmacy in Farmington, New Mexico and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through May 5, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1710993118
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address4221 E MAIN STFarmington, NM 87402-8637
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-3489 · Fax (217) 709-2344
Phone(505) 325-1749
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateJuly 31, 2006
Last NPPES UpdateMarch 27, 20264 updates tracked since enumeration
NPPES CertifiedMarch 27, 2026
✔ NPI 1710993118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in NM · PH00004082
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
4221 E MAIN ST, Farmington, NM 87402
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Other Names 1

Doing Business AsWalgreens #04510

Other Identifiers 2

Other3209358Other Id Number-commercial Number
Medicaid60749NM

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 32D2223411

Walgreens #04510 · Farmington, NM
Active · expires May 5, 2027
CLIA Number32D2223411
Laboratory TypePharmacy
Certificate Effective DateMay 6, 2025
Certificate Expiration DateMay 5, 2027
Laboratory DirectorJeff Bettner
Laboratory Phone(505) 325-1749
Laboratory LocationWalgreens #045104221 E Main St, Farmington, NM 87402
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 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.
215 services214 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.
143 services143 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.
57 services57 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.
36 services36 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.
36 services36 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #4510 carries, from the Medicare DMEPOS supplier directory.

Walgreens #4510

DMEPOS supplier · Farmington, NMOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #4510 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)20358113
Medicare Participant SinceMarch 1, 2022
Supplier Location4221 E Main StFarmington, NM 87402
Phone(505) 325-1749
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 5

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

JENNIFER RAE SMITH PHARMD
Pharmacist
4221 E MAIN ST
FARMINGTON, NM 87402
San Juan County (505) 325-1749
DR. JEFFERY SCOTT NYGREN JR. PHARM D
Pharmacist
4221 E MAIN ST
FARMINGTON, NM 87402
San Juan County (505) 325-1749
PERCY E COLLYER PHARMD
Pharmacist
4221 E MAIN ST
FARMINGTON, NM 87402
San Juan County (505) 325-1749
BRIANNA LEWIS PHARMD
Pharmacist
4221 E MAIN ST
FARMINGTON, NM 87402
San Juan County (505) 325-1749
ELIZABETH LAUREN REECE
Pharmacist (Ambulatory Care)
4221 E MAIN ST
FARMINGTON, NM 87402
San Juan County (505) 325-1749

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 1710993118. It was assigned to this organization in the NPPES registry on July 31, 2006. The provider is doing business as Walgreens #04510.

Where is Walgreen Co located?

Walgreen Co is located at 4221 E Main St, Farmington, NM 87402. The listed phone number is (505) 325-1749.

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 #4510 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 32D2223411) is associated with this NPI, valid through May 5, 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 39 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 March 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.