Walgreen Co
NPI 1629083761ActiveOrganization· Pharmacy· Mattoon, IL
Pharmacy in Mattoon, Illinois, registered in NPPES in July 2006, part of Walgreens Boots Alliance Inc. The authorized official on file is Kira L. Taylor, Manager. Medicare paid $116,039 for services to 454 patients in 2024.
Overview
| NPI | 1629083761 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Boots Alliance Inc |
| NPI issued | Jul 29, 2006 |
| Last updated in NPPES | Apr 27, 2022 |
| Certified by provider | Apr 27, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 54004542 | IL |
| 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 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (IL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 454 |
|---|---|
| Services billed | 1,478 across 12 procedure codes |
| Paid by Medicare | $116,039 |
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