WALGREENS #03957
NPI 1902811938
Pharmacy in Dallas, TX

Q: What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1902811938. It was assigned to this organization in the NPPES registry on July 29, 2006. The provider is doing business as Walgreens #03957.

Q: What is Walgreen Co's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Q: When was this NPI record last updated?

The NPPES record for Walgreen Co was last updated on February 20, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 29, 2006CLIA 45D2071941 · Waiver

5101 S LANCASTER RD, DALLAS, TX 75241(214) 375-7103(214) 375-7114 Get Directions Write a Review

NPPES record last updated: February 20, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 20, 2023, May 8, 2019, Nov 17, 2016 (3 updates tracked since 2016).

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About Walgreens #03957 NPPES

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

WALGREENS #03957 (NPI 1902811938) is a healthcare organization registered as a pharmacy in Dallas, Texas and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through June 29, 2027 and lists Kira L Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1902811938

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address5101 S LANCASTER RDDallas, TX 75241-1328

Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344

Phone(214) 375-7103

Fax(214) 375-7114

Organization SubpartYesParent: Walgreens Boots Alliance Inc

Authorized OfficialKira L TaylorManager · (217) 709-2351

Enumeration DateJuly 29, 2006

Last NPPES UpdateFebruary 20, 20233 updates tracked since enumeration

NPPES CertifiedFebruary 20, 2023

✔ NPI 1902811938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in TX · 17613

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 ListedClinical Medical LaboratoryTaxonomy 291U00000X

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X

5101 S LANCASTER RD, Dallas, TX 75241

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Other Names 1

Doing Business AsWalgreens #03957

Other Identifiers 3

Medicaid464020TX

Medicaid468897TX

Other4599455Other Id Number-commercial Number

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 45D2071941

Walgreens #3957 · Dallas, TX

Active · expires Jun 29, 2027

CLIA Number45D2071941

Laboratory TypePharmacy

Certificate Effective DateJune 30, 2025

Certificate Expiration DateJune 29, 2027

Laboratory DirectorMatthew Villavasso

Laboratory Phone(214) 375-7103

Laboratory LocationWalgreens #39575101 S Lancaster Rd, Dallas, TX 75241

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 3

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.

37 services36 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.

17 services17 patients

Influenza vaccine, inactivated 90653

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.

12 services12 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreen Co carries, from the Medicare DMEPOS supplier directory.

Walgreen Co

DMEPOS supplier · Dallas, TX

✔

Accepts Medicare assignment

Walgreen Co 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)20390513

Medicare Participant SinceMarch 1, 2022

Supplier Location5101 S Lancaster RdDallas, TX 75241

Phone(214) 375-7103

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.

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Other Providers at the Same Location NPPES 5

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

DR. JARRYN L CLEAVES PHARMD

Pharmacist