Walgreen Co
NPI 1407102106ActiveOrganization· Pharmacy· Sullivan, MO
Pharmacy in Sullivan, Missouri, registered in NPPES in July 2012, part of Walgreens Boots Alliance Inc. The authorized official on file is Kira Taylor, Manager. Medicare paid $29,170 for services to 124 patients in 2024.
Overview
| NPI | 1407102106 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Boots Alliance Inc |
| NPI issued | Jul 31, 2012 |
| Last updated in NPPES | May 3, 2022 |
| Certified by provider | May 3, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 2017006068 | MO |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (MO) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 124 |
|---|---|
| Services billed | 386 across 9 procedure codes |
| Paid by Medicare | $29,170 |
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