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WALGREENS #19121
NPI 1770006769
Pharmacy in Salt Lake City, UT

Active since July 21, 2017CLIA 46D2287543 · Waiver
72 S MAIN ST, SALT LAKE CITY, UT 84101(801) 531-0583(801) 521-0554 Get Directions Write a Review

NPPES record last updated: June 7, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 7, 2022, Nov 2, 2018, Dec 20, 2017 and 1 more (4 updates tracked since 2017).

About Walgreens #19121 NPPES

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

WALGREENS #19121 (NPI 1770006769) is a healthcare organization registered as a pharmacy in Salt Lake City, Utah and active in the NPI registry since July 2017. The organization holds a CLIA Waiver certificate valid through August 14, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1770006769
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address72 S MAIN STSalt Lake City, UT 84101-1506
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Phone(801) 531-0583
Fax(801) 521-0554
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateJuly 21, 2017
Last NPPES UpdateJune 7, 20224 updates tracked since enumeration
NPPES CertifiedJune 7, 2022
✔ NPI 1770006769 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
72 S MAIN ST, Salt Lake City, UT 84101
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Other Names 1

Doing Business AsWalgreens #19121

Other Identifiers 2

Other10604296-1703UT · Board Of Pharmacy
Medicaid3005107UT

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 46D2287543

Walgreens 19121 · Salt Lake City, UT
Active · expires Aug 14, 2027
CLIA Number46D2287543
Laboratory TypePharmacy
Certificate Effective DateAugust 15, 2025
Certificate Expiration DateAugust 14, 2027
Laboratory DirectorNatalia Ruiz-Negron
Laboratory Phone(801) 531-0583
Laboratory LocationWalgreens 1912172 South Main Street, Salt Lake City, UT 84101
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #19121 carries, from the Medicare DMEPOS supplier directory.

Walgreens #19121

DMEPOS supplier · Salt Lake City, UTOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #19121 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)20397161
Medicare Participant SinceMarch 1, 2022
Supplier Location72 S Main StSalt Lake City, UT 84101
Phone(801) 531-0583
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

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

MI HUI WRIGHT RPH
Pharmacist
72 S MAIN ST
SALT LAKE CITY, UT 84101
Salt Lake County (801) 531-0583

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 1770006769. It was assigned to this organization in the NPPES registry on July 21, 2017. The provider is doing business as Walgreens #19121.

Where is Walgreen Co located?

Walgreen Co is located at 72 S Main St, Salt Lake City, UT 84101. The listed phone number is (801) 531-0583.

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 #19121 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 46D2287543) is associated with this NPI, valid through August 14, 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 41 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 June 7, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.