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WALGREENS #11693
NPI 1780820209
Pharmacy in Spring Lake, NC

Active since January 06, 2009CLIA 34D2041605 · Waiver
200 N BRAGG BLVD, SPRING LAKE, NC 28390(910) 436-0471(910) 436-3647 Get Directions Write a Review

NPPES record last updated: November 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 7, 2023, Jan 11, 2016 (2 updates tracked since 2016).

About Walgreens #11693 NPPES

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

WALGREENS #11693 (NPI 1780820209) is a healthcare organization registered as a pharmacy in Spring Lake, North Carolina and active in the NPI registry since January 2009. The organization holds a CLIA Waiver certificate valid through August 16, 2027 and lists Kira Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1780820209
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address200 N BRAGG BLVDSpring Lake, NC 28390-3350
Mailing Address1901 E Voorhees St, Ms #790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Phone(910) 436-0471
Fax(910) 436-3647
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira TaylorManager · (217) 709-2351
Enumeration DateJanuary 6, 2009
Last NPPES UpdateNovember 7, 20232 updates tracked since enumeration
NPPES CertifiedNovember 7, 2023
✔ NPI 1780820209 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in NC · 10296
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
200 N BRAGG BLVD, Spring Lake, NC 28390
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Other Names 1

Doing Business AsWalgreens #11693

Other Identifiers 2

Other3413414Ncpdp
Medicaid0266434NC

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 34D2041605

Walgreens #11693 · Spring Lake, NC
Active · expires Aug 16, 2027
CLIA Number34D2041605
Laboratory TypePharmacy
Certificate Effective DateAugust 17, 2025
Certificate Expiration DateAugust 16, 2027
Laboratory DirectorSierra Taylor
Laboratory Phone(910) 436-0471
Laboratory LocationWalgreens #11693200 N Bragg Blvd, Spring Lake, NC 28390
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.
30 services30 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.
15 services15 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #11693 carries, from the Medicare DMEPOS supplier directory.

Walgreens #11693

DMEPOS supplier · Spring Lake, NCOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #11693 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)20388425
Medicare Participant SinceMarch 1, 2022
Supplier Location200 N Bragg BlvdSpring Lake, NC 28390
Phone(910) 436-0471
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 3

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

MR. NITINCHANDRA PRABHUDAS AVLANI PHARMACIST
Pharmacist
200 N BRAGG BLVD
SPRING LAKE, NC 28390
Cumberland County (910) 436-0471
DR. STELLA C NEBOLISA PHARMD
Pharmacist
200 N BRAGG BLVD
SPRING LAKE, NC 28390
Cumberland County (910) 436-0471
MEGAN PALMIER
Pharmacist
200 N BRAGG BLVD
SPRING LAKE, NC 28390
Cumberland County (910) 436-0471

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 1780820209. It was assigned to this organization in the NPPES registry on January 6, 2009. The provider is doing business as Walgreens #11693.

Where is Walgreen Co located?

Walgreen Co is located at 200 N Bragg Blvd, Spring Lake, NC 28390. The listed phone number is (910) 436-0471.

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 #11693 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 34D2041605) is associated with this NPI, valid through August 16, 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 November 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.