WALGREENS #18211
NPI 1952829194
Pharmacy in Fredericksburg, VA

NPI Status: Active since September 08, 2017

Contact Information

11129 GORDON RD
FREDERICKSBURG, VA
ZIP 22407
Phone: (540) 785-6634
Fax: (540) 785-6671

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  • Organization
  • Pharmacy
  • Accepts Insurance
  • Medicare Supplier
  • Accepts Medicare Approved Payment
  • CLIA Number: 49D2221710
  • CLIA Cert. Type: Pharmacy
  • CLIA Exp. Date: 04-22-2027

About WALGREENS #18211

This page provides the complete NPI Profile along with additional information for Walgreens #18211, a provider established in Fredericksburg, Virginia operating as a Pharmacy. The healthcare provider is registered in the NPI registry with number 1952829194 assigned on September 2017. The practitioner's primary taxonomy code is 333600000X with license number 0201004207 (VA). The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Walgreens #18211. The authorized official of this NPI record is Kira Taylor (Manager)

NPI
1952829194
Provider Legal Name
WALGREEN CO
Other Organization Name
WALGREENS #18211
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
11129 GORDON RD FREDERICKSBURG, VA 22407
Location Phone
(540) 785-6634
Location Fax
(540) 785-6671
Mailing Address
1901 E VOORHEES ST MS 790 DANVILLE, IL 61834
Mailing Phone
(217) 709-2351
Mailing Fax
(540) 785-6671
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
09-08-2017
Last Update Date
06-03-2022
Code Navigator



Walgreens #18211 is a medicare supplier with PTAN 20398229 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Infusion Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Blood Glucose Monitors/Supplies (Non-Mail Order).

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy

Taxonomy Code
333600000X
Type
Suppliers
License No.
0201004207
License State
VA
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1332B00000XSuppliers

Durable Medical Equipment & Medical Supplies

 
23336C0003XSuppliers

Pharmacy
Community/Retail Pharmacy

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Balance by Medica Bronze $0 Copay PCP Visits - EPO
  • Balance by Medica Bronze $0 Copay PCP Visits - PPO
  • Balance by Medica Bronze Premier - EPO
  • Balance by Medica Bronze Premier - PPO
  • Balance by Medica Expanded Bronze Standard - EPO
  • Balance by Medica Expanded Bronze Standard - PPO
  • Balance by Medica Gold $0 Copay PCP Visits - EPO
  • Balance by Medica Gold $0 Copay PCP Visits - PPO
  • Balance by Medica Gold Share - EPO
  • Balance by Medica Gold Share - PPO
  • Balance by Medica Gold Standard - EPO
  • Balance by Medica Gold Standard - PPO
  • Balance by Medica Silver $0 Copay PCP Visits - EPO
  • Balance by Medica Silver $0 Copay PCP Visits - PPO
  • Balance by Medica Silver Share - EPO
  • Balance by Medica Silver Share - PPO
  • Balance by Medica Silver Standard - EPO
  • Balance by Medica Silver Standard - PPO
  • Elevate by Medica Bronze $0 Copay PCP Visits - EPO
  • Elevate by Medica Bronze Share - EPO
  • Moda Health Affinity Bronze 8000 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO
  • Moda Health Oregon Standard Bronze Affinity - EPO
  • Moda Health Oregon Standard Gold Affinity - EPO
  • Moda Health Oregon Standard Silver Affinity - EPO
  • Moda Select Alaska Bronze 6500 - PPO
  • Moda Select Alaska Bronze HDHP 5500 - PPO
  • Moda Select Alaska Gold 1500 - PPO
  • Moda Select Alaska Silver 4500 - PPO
  • Moda Select Alaska Standard Bronze - PPO
  • Moda Select Alaska Standard Gold - PPO
  • Moda Select Alaska Standard Silver - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KIRA TAYLOR

Authorized Official Title
MANAGER
Authorized Official Phone
(217) 709-2351

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
4848719OTHER (01)VANCPDP
1952829194MEDICAID (05)VA 

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20398229
Accepts Medicare Assignment
YES
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • 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
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
49D2221710
Facility Type
Pharmacy
Certificate Effective Date
April 23, 2025
Certificate Expiration Date
April 22, 2027
Laboratory Director
NGA T. PHAM
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Walgreens #18211 to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1952829194, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
2
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
2
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
1
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 8 → 16 → 7 9 → 18 → 9 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 1 + 0 + 2 + 1 + 6 + 2 + 1 + 8 + 1 + 1 + 8 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1952829194.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Pharmacist
11129 GORDON RD
FREDERICKSBURG, VA 22407
Pharmacist
11129 GORDON RD
FREDERICKSBURG, VA 22407

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1952829194, enumerated as an "organization" on September 08, 2017.

The provider is located at 11129 GORDON RD FREDERICKSBURG, VA 22407 and the phone number is (540) 785-6634.

Pharmacy with taxonomy code 333600000X.

The provider might be accepting Accepts: Medica, Moda Health Plan, Inc., Medicare and. Please consult your insurance carrier or call the provider to verify.