WALGREEN CO NPI 1972763092

NPI Details

WALGREEN CO is a pharmacy in Diberville, MS. 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 1972763092. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens 10909.

The provider's business location address is:

12007 LAMEY BRIDGE RD
DIBERVILLE, MS
ZIP 39540-907
Phone: (228) 392-2388
Fax: (228) 392-6857

The provider's authorized official is Jennifer Ponce .
The authorized official title is Manager and has the following contact phone number (847) 527-2489.

The CLIA number assigned to this NPI record is 25D2037882 - 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)
• Influenza vaccine split virus, preservative free (HCPCS:90662)
• Fee covid-19 vac 13 res (HCPCS:0124A)
• Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
• Adm sarscv2 30mcg trs-sucr b (HCPCS:0054A)
• 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)

The enumeration date for this NPI number is 6/12/2008 and was last updated on 10/10/2024.

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:

Other Identifiers

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