WALGREEN CO NPI 1912912023

NPI Information

  • NPI: 1912912023
  • Provider Name: WALGREEN CO
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Doing Business As: WALGREENS #04635
  • CLIA Number: 15D2011531
  • Address: 101 W US HIGHWAY 20
    MICHIGAN CITY, IN
    ZIP 46360
  • Phone: (219) 879-9650

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NPI Details

WALGREEN CO is a pharmacy in Michigan City, IN. 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 1912912023. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens #04635.

The provider's business location address is:

101 W US HIGHWAY 20
MICHIGAN CITY, IN
ZIP 46360-337
Phone: (219) 879-9650

The provider's authorized official is Kira L 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 15D2011531 - 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 split virus, preservative free (HCPCS:90662)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Adm sarscv2 30mcg trs-sucr b (HCPCS:0054A)
  • Fee covid-19 vac 13 res (HCPCS:0124A)
  • Adm sarscov2 100mcg/0.5ml3rd (HCPCS:0013A)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
  • Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free (HCPCS:90674)
  • Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage (HCPCS:90686)
  • Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; second dose (HCPCS:0012A)

The enumeration date for this NPI number is 7/29/2006 and was last updated on 4/12/2022.

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
3333600000XPharmacy600011643CYINDIANAYes

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
1100308180A DMEMEDICAIDINDIANA
21502459OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
3100308180MEDICAIDINDIANA

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: 11/21/2025

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