WALGREENS #06063 - NPI 1912913567 - Pharmacy in Phoenix, AZ

Q: What is the provider's specialty?

The provider's specialty is Pharmacy with taxonomy code 333600000X.

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About Walgreens #06063 NPPES

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

WALGREENS #06063 (NPI 1912913567) is a healthcare organization registered as a pharmacy in Phoenix, Arizona and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through April 18, 2027 and lists Kira L Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1912913567

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address1825 W BETHANY HOME RDPhoenix, AZ 85015-2512

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

Phone(602) 249-1285

Organization SubpartYesParent: Walgreens Boots Alliance Inc

Authorized OfficialKira L TaylorManager · (217) 709-2351

Enumeration DateAugust 1, 2006

Last NPPES UpdateMay 3, 20224 updates tracked since enumeration

NPPES CertifiedMay 3, 2022

✔ NPI 1912913567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in AZ · Y00461

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

1825 W BETHANY HOME RD, Phoenix, AZ 85015

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Other Names 1

Doing Business AsWalgreens #06063

Other Identifiers 2

Medicaid038069AZ

Other0303177Other 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 03D2063111

Walgreens #06063 · Phoenix, AZ

Active · expires Apr 18, 2027

CLIA Number03D2063111

Laboratory TypePharmacy

Certificate Effective DateApril 19, 2025

Certificate Expiration DateApril 18, 2027

Laboratory DirectorLouis J. Briatta

Laboratory Phone(602) 249-1285

Laboratory LocationWalgreens #060631825 W Bethany Home Rd, Phoenix, AZ 85015

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

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

DR. SUZANNE ELIZABETH HOLMES PHARMD

Pharmacist