WALGREEN CO
NPI 1730475435
Pharmacy in Eastvale, CA

Active since June 22, 2011CLIA 05D2063079 · Waiver
12574 LIMONITE AVE, EASTVALE, CA 91752(951) 520-0187(951) 520-0386 Get Directions Write a Review

NPPES record last updated: June 10, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 12, 2022, Oct 11, 2018, Jan 13, 2016 (3 updates tracked since 2016).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1730475435), doing business as Walgreens #13657, is a healthcare organization registered as a pharmacy in Eastvale, California and active in the NPI registry since June 2011. The organization holds a CLIA Waiver certificate valid through May 9, 2028 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1730475435
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address12574 LIMONITE AVEEastvale, CA 91752-3684
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2345
Fax(951) 520-0386
Organization SubpartYesParent: Walgreens Holding Company
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateJune 22, 2011
Last NPPES UpdateJune 10, 20263 updates tracked since enumeration
NPPES CertifiedJune 10, 2026
NPI 1730475435 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in CA · PHY50682
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
12574 LIMONITE AVE, Eastvale, CA 91752

Other Names 1

Doing Business AsWalgreens #13657

Other Identifiers 2

Medicaid1730475435CA
Other5641457CA · Ncpdp

Accepted Insurance

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of influenza virus vaccine

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.

This service was performed 61 times for 61 patients

Administration of pneumococcal vaccine

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.

This service was performed 13 times for 13 patients

Influenza vaccine split virus, preservative free

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.

This service was performed 28 times for 28 patients

Influenza vaccine, inactivated

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.

This service was performed 22 times for 22 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use

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.

This service was performed 12 times for 12 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20383649
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

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2063079
Facility Type
Pharmacy
Certificate Effective Date
May 10, 2026
Certificate Expiration Date
May 09, 2028
Laboratory Director
TIFFANY T. NGUYEN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Walgreen Co to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for WALGREEN CO

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Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Pharmacist
12574 LIMONITE AVE
EASTVALE, CA 91752
Pharmacist
12574 LIMONITE AVE
EASTVALE, CA 91752

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1730475435, enumerated as an "organization" on June 22, 2011.

The provider is located at 12574 LIMONITE AVE EASTVALE, CA 91752 and the phone number is (951) 520-0187.

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.