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WALGREEN CO
NPI 1790448298
Pharmacy in Prineville, OR

Active since October 21, 2021CLIA 38D2311791 · Waiver
174 NE SAINT CHARLES WAY, PRINEVILLE, OR 97754(541) 447-0395 Get Directions Write a Review

NPPES record last updated: September 9, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Sep 9, 2025, Jul 21, 2023, Jan 7, 2022 and 1 more (4 updates tracked since 2021).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1790448298), doing business as Walgreens #21434, is a healthcare organization registered as a pharmacy in Prineville, Oregon and active in the NPI registry since October 2021. The organization holds a CLIA Waiver certificate valid through September 29, 2026 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1790448298
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address174 NE SAINT CHARLES WAYPrineville, OR 97754-2568
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Phone(541) 447-0395
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateOctober 21, 2021
Last NPPES UpdateSeptember 9, 20254 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2025
✔ NPI 1790448298 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

Other Names 1

Doing Business AsWalgreens #21434

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 38D2311791

Walgreens 21434 · Prineville, OR
Active · expires Sep 29, 2026
CLIA Number38D2311791
Laboratory TypePharmacy
Certificate Effective DateSeptember 30, 2024
Certificate Expiration DateSeptember 29, 2026
Laboratory DirectorRichard T. Lutz
Laboratory Phone(541) 447-0395
Laboratory LocationWalgreens 21434174 NE Saint Charles Wy, Prineville, OR 97754
CLIA data matches this NPI record on: 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 #21434 carries, from the Medicare DMEPOS supplier directory.

Walgreens #21434

DMEPOS supplier · Prineville, OROperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #21434 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)20382719
Medicare Participant SinceMarch 1, 2022
Supplier Location174 NE Saint Charles WayPrineville, OR 97754
Phone(541) 447-0395
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.

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 1790448298. It was assigned to this organization in the NPPES registry on October 21, 2021. The provider is doing business as Walgreens #21434.

Where is Walgreen Co located?

Walgreen Co is located at 174 NE Saint Charles Way, Prineville, OR 97754. The listed phone number is (541) 447-0395.

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 #21434 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 38D2311791) is associated with this NPI, valid through September 29, 2026. 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 38 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 September 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.