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WALGREEN CO
NPI 1720419005
Pharmacy in Edmonds, WA

Active since December 11, 2013CLIA 50D2083868 · Waiver
9797 EDMONDS WAY, EDMONDS, WA 98020(425) 672-0017(425) 672-1019 Get Directions Write a Review

NPPES record last updated: March 28, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 28, 2025, Apr 28, 2022, May 10, 2018 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 1720419005), doing business as Walgreens #15404, is a healthcare organization registered as a pharmacy in Edmonds, Washington and active in the NPI registry since December 2013. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1720419005
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address9797 EDMONDS WAYEdmonds, WA 98020-5939
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (847) 527-2489 · Fax (217) 709-2344
Phone(425) 672-0017
Fax(425) 672-1019
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateDecember 11, 2013
Last NPPES UpdateMarch 28, 20254 updates tracked since enumeration
NPPES CertifiedMarch 28, 2025
✔ NPI 1720419005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in WA · CF60435101
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
9797 EDMONDS WAY, Edmonds, WA 98020
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Other Names 1

Doing Business AsWalgreens #15404

Other Identifiers 2

Other4935714WA · Ncpdp
Medicaid2034414WA

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 50D2083868

Walgreens #15404 · Edmonds, WA
Active · expires Apr 4, 2028
CLIA Number50D2083868
Laboratory TypePharmacy
Certificate Effective DateDecember 18, 2020
Certificate Expiration DateApril 4, 2028
Laboratory DirectorAnn Q. Minn
Laboratory Phone(425) 672-0017
Laboratory LocationWalgreens #154049797 Edmonds Way, Edmonds, WA 98020
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 2

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.
203 services203 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.
196 services196 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #15404 carries, from the Medicare DMEPOS supplier directory.

Walgreens #15404

DMEPOS supplier · Edmonds, WAOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #15404 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)20385827
Medicare Participant SinceMarch 1, 2022
Supplier Location9797 Edmonds WayEdmonds, WA 98020
Phone(425) 672-0017
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 2

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

JIHYANG LEE
Pharmacist
9797 EDMONDS WAY
EDMONDS, WA 98020
Snohomish County (425) 672-0017
SALLY MARSOLAIS KALLAWAY PHARMD
Pharmacist
9797 EDMONDS WAY
EDMONDS, WA 98020
Snohomish County (425) 672-0017

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 1720419005. It was assigned to this organization in the NPPES registry on December 11, 2013. The provider is doing business as Walgreens #15404.

Where is Walgreen Co located?

Walgreen Co is located at 9797 Edmonds Way, Edmonds, WA 98020. The listed phone number is (425) 672-0017.

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 #15404 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 50D2083868) is associated with this NPI, valid through April 4, 2028. 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 40 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 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.