NPIMap

Organization Active NPI

Walgreen Co.

  • Institutional Pharmacy
  • Pella, IA
National Provider Identifier
1164578134
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
Legal business name
WALGREEN CO.
Practice address
1610 E Vermeer Rd # Plant 3 1/2 Ste 100RX
Pella, IA 50219-7658
Phone
(641) 651-3034
Fax
(641) 651-3037
NPI assigned
Jan 25, 2007
Organization subpart
Yes
Parent organization
WALGREEN CO.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kira Taylor
Title
Manager
Phone
(217) 709-2351

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 1286 IA
Institutional Pharmacy 3336I0012X Primary

Addresses

Primary practice location

1610 E Vermeer Rd # Plant 3 1/2 Ste 100RX
Pella, IA 50219-7658

Mailing address

1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 709-2351

Other identifiers 1

IdentifierTypeStateIssuer
1622542OtherNCPDP

Other names 1

  • Vermeer Family Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070917000779 TX Part B Supplier - Centralized Flu Biller 0941278253 This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D2175200Vermeer Family Pharmacy1610 E Vermeer Rd, Plant 3&1/2, Ste 100RX, Pella, IA 50219Certificate of waiverNov 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Walgreen Co8,684 organizations share this tax ID, including this one
Part of
Walgreens 16466

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1610 E Vermeer Rd
Ste 100RX
Pella, IA 50219
Phone (641) 651-3034

1610 E Vermeer Rd
#3
Pella, IA 50219
Phone (641) 621-7470

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691625600000",
    "number": "1164578134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST",
            "address_2": "MS 790",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618344509",
            "telephone_number": "217-709-2351",
            "fax_number": "217-709-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 E VERMEER RD # PLANT 3 1/2 STE 100RX",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502197658",
            "telephone_number": "641-651-3034",
            "fax_number": "641-651-3037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN CO.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREEN CO.",
        "enumeration_date": "2007-01-25",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "KIRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "217-709-2351"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IA",
            "license": "1286",
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1622542",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vermeer Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vermeer Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pella, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.