WALGREEN CO NPI 1124291497

NPI Information

  • NPI: 1124291497
  • Provider Name: WALGREEN CO
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Doing Business As: WALGREENS # 11773
  • CLIA Number: 49D2052316
  • Address: 3220 HALIFAX RD
    SOUTH BOSTON, VA
    ZIP 24592
  • Phone: (434) 575-5338

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NPI Details

WALGREEN CO is a pharmacy in South Boston, VA. The provider is 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. WALGREEN CO NPI is 1124291497. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens # 11773.

The provider's business location address is:

3220 HALIFAX RD
SOUTH BOSTON, VA
ZIP 24592-908
Phone: (434) 575-5338
Fax: (434) 575-5976

The provider's authorized official is Kira Taylor .
The authorized official title is Manager and has the following contact phone number (217) 709-2351.

The CLIA number assigned to this NPI record is 49D2052316 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count (HCPCS:K1034)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage (HCPCS:90686)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
  • Adm sarscov2 100mcg/0.5ml3rd (HCPCS:0013A)

The enumeration date for this NPI number is 4/8/2008 and was last updated on 10/30/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacy0201004229VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10497707MEDICAIDNORTH CAROLINA
24840814OTHERNCPDP
31124291497MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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