WALGREENS #03642
NPI 1952316911
Pharmacy in Oklahoma City, OK

NPI Status: Active since July 29, 2006

Contact Information

4500 S SHIELDS BLVD
OKLAHOMA CITY, OK
ZIP 73129
Phone: (405) 631-3561

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  • Organization
  • Pharmacy
  • Accepts Insurance
  • Medicare Supplier
  • Accepts Medicare Approved Payment
  • CLIA Number: 37D2012832
  • CLIA Cert. Type: Pharmacy
  • CLIA Exp. Date: 07-27-2025

About WALGREENS #03642

This page provides the complete NPI Profile along with additional information for Walgreens #03642, a provider established in Oklahoma City, Oklahoma operating as a Pharmacy. The healthcare provider is registered in the NPI registry with number 1952316911 assigned on July 2006. The practitioner's primary taxonomy code is 333600000X with license number 1-3961 (OK). The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Walgreens #03642. The authorized official of this NPI record is Kira Taylor (Manager)

NPI
1952316911
Provider Legal Name
WALGREEN CO
Other Organization Name
WALGREENS #03642
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
4500 S SHIELDS BLVD OKLAHOMA CITY, OK 73129
Location Phone
(405) 631-3561
Mailing Address
1901 E VOORHEES ST MAILSTOP #790 DANVILLE, IL 61834
Mailing Phone
(217) 709-2351
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
07-29-2006
Last Update Date
11-03-2023
Code Navigator



Walgreens #03642 is a medicare supplier with PTAN 20392097 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Infusion Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Blood Glucose Monitors/Supplies (Non-Mail Order).

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy

Taxonomy Code
333600000X
Type
Suppliers
License No.
1-3961
License State
OK
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1332B00000XSuppliers

Durable Medical Equipment & Medical Supplies

 
23336C0003XSuppliers

Pharmacy
Community/Retail Pharmacy

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Cross Select Gold - PPO
  • Blue Cross Select Silver - PPO
  • Blue HSA Bronze - PPO
  • Blue Protect - PPO
  • Blue Saver Bronze - PPO
  • Blue Saver Silver EPO - EPO
  • Blue Standardized Bronze - PPO
  • Blue Standardized Gold - PPO
  • Blue Standardized Silver - PPO
  • Blue Standardized Silver EPO - EPO
  • Blue Value Gold - PPO
  • Blue Value Silver - PPO
  • Blue Access Gold for Business - PPO
  • Blue Choice Platinum for Business - PPO
  • Blue HSA Silver for Business - PPO
  • Blue Saver Bronze for Business - PPO
  • Blue Saver Gold for Business - PPO
  • Blue Secure Gold for Business - PPO
  • Blue Secure Silver for Business - PPO
  • Blue Choice Preferred Bronze PPO? 201 - PPO
  • Blue Choice Preferred Bronze PPO? 701 - PPO
  • Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
  • Blue Choice Preferred Gold PPO? 204 - PPO
  • Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
  • Blue Choice Preferred Security PPO? 200 - PPO
  • Blue Choice Preferred Silver PPO? 203 - PPO
  • Blue Choice Preferred Silver PPO? 801 - PPO
  • Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
  • Blue Precision Bronze HMO? 205 - HMO
  • Blue Precision Bronze HMO? 701 - HMO
  • Blue Precision Bronze HMO? Standard - Select Rx Copays - HMO
  • Blue Precision Gold HMO? 207 - HMO
  • Blue Precision Gold HMO? 703 - HMO
  • Blue Precision Gold HMO? Standard - Rx Copays - HMO
  • Blue Precision Silver HMO? 206 - HMO
  • Blue Precision Silver HMO? 704 - HMO
  • Blue Precision Silver HMO? Standard - Select Rx Copays - HMO
  • BlueCare Direct Bronze? Standard - Select Rx Copays with Advocate - HMO
  • BlueCare Direct Gold? Standard - Rx Copays with Advocate - HMO
  • Blue Focus Bronze POS? 205 - POS
  • Blue Focus Bronze POS? 705 - POS
  • Blue Focus Bronze POS? Standard - POS
  • Blue Focus Gold POS? 207 - POS
  • Blue Focus Gold POS? Standard - POS
  • Blue Focus Silver POS? 206 - POS
  • Blue Focus Silver POS? Standard - POS
  • Blue Preferred Bronze PPO? 201 - PPO
  • Blue Preferred Bronze PPO? 202 - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? 204 - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? 203 - PPO
  • Blue Preferred Silver PPO? 308 - PPO
  • Blue Preferred Silver PPO? Standard - PPO
  • Blue Advantage Bronze PPO? 202 - PPO
  • Blue Advantage Bronze PPO? 203 - PPO
  • Blue Advantage Bronze PPO? Standard - PPO
  • Blue Advantage Gold PPO? 309 - PPO
  • Blue Advantage Gold PPO? 604 - PPO
  • Blue Advantage Gold PPO? Standard - PPO
  • Blue Advantage Silver PPO? 204 - PPO
  • Blue Advantage Silver PPO? 501 - PPO
  • Blue Advantage Silver PPO? Standard - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? Standard - PPO
  • MyBlue Gold HMO? 704 - HMO
  • MyBlue Gold HMO? 804 - HMO
  • MyBlue Gold HMO? Standard - HMO
  • MyBlue Silver HMO? 705 - HMO
  • MyBlue Silver HMO? 803 - HMO
  • MyBlue Silver HMO? Standard - HMO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • MyBlue Health Bronze? 402 - HMO
  • BlueCare Gold $25 PCP Copay ($5 Value Based Drug List) - PPO
  • BlueCare Silver $45 PCP Copay ($5 Value Based Drug List) - PPO
  • BlueDirect Bronze 100 HSA Eligible ($7500 Deductible / $5 Preventive Drug List) - PPO
  • BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) - PPO
  • BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) - PPO
  • BlueEssential Catastrophic 100 $9200 Deductible - PPO
  • BlueValue Bronze $50 PCP Copay (Standardized plan) - PPO
  • BlueValue Gold $30 PCP Copay (Standardized plan) - PPO
  • BlueValue Silver $40 PCP Copay (Standardized plan) - PPO
  • DakotaBlue Altru Gold ($5 Value Based Drug List) - PPO
  • DakotaBlue Altru Silver ($5 Value Based Drug List) - PPO
  • DakotaBlue Trinity Gold ($5 Value Based Drug List) - PPO
  • DakotaBlue Trinity Silver ($5 Value Based Drug List) - PPO
  • BlueSelect Bronze Basic - PPO
  • BlueSelect Bronze Core - PPO
  • BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
  • BlueSelect Gold Core - PPO
  • BlueSelect Gold HealthPlus - PPO
  • BlueSelect Gold Standard without Kid's Dental - PPO
  • BlueSelect Silver Classic - PPO
  • BlueSelect Silver Classic without Kid's Dental - PPO
  • BlueSelect Silver HealthPlus - PPO
  • BlueSelect Silver HealthPlus without Kid's Dental - PPO
  • BlueSelect Silver Standard without Kid's Dental - PPO
  • Select by Medica Bronze $0 Copay PCP Visits - EPO
  • Select by Medica Bronze Share - EPO
  • Select by Medica Expanded Bronze Standard - EPO
  • Select by Medica Gold $0 Copay PCP Visits - EPO
  • Select by Medica Gold Share - EPO
  • Select by Medica Gold Standard - EPO
  • Select by Medica Silver $0 Copay PCP Visits - EPO
  • Select by Medica Silver Share - EPO
  • Select by Medica Silver Standard - EPO
  • Moda Health Affinity Bronze 7750 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO
  • Moda Health Oregon Standard Bronze Affinity - EPO
  • Moda Health Oregon Standard Gold Affinity - EPO
  • Moda Health Oregon Standard Silver Affinity - EPO
  • Moda Pioneer Alaska Standard Bronze - PPO
  • Moda Pioneer Alaska Standard Gold - PPO
  • Moda Pioneer Alaska Standard Silver - PPO
  • Moda Pioneer Bronze 6500 - PPO
  • Moda Pioneer Bronze HDHP 5500 - PPO
  • Moda Pioneer Gold 1500 - PPO
  • Moda Pioneer Silver 4500 - PPO
  • Essential Bronze 6500 - POS
  • Essential Gold 1500 - POS
  • Freedom Silver 4000 - POS
  • Savings Bronze 7700 - POS
  • Standard Bronze 7500 - POS
  • Standard Gold 1500 - POS
  • Standard Silver 5000 - POS

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KIRA TAYLOR

Authorized Official Title
MANAGER
Authorized Official Phone
(217) 709-2351

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
100815500A DMEMEDICAID (05)OK 
100243910AMEDICAID (05)OK 
3720213OTHER (01)OTHER ID NUMBER-COMMERCIAL NUMBER

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Adm sarscv2 30mcg trs-sucr b

This service involves the administration of a 30mcg dose of the SARS-CoV-2 vaccine, which helps protect against COVID-19. The 'trs-sucr b' indicates it's stabilized with sugars for effectiveness. It's a crucial step in maintaining your health during the pandemic.

This service was performed 12 times for 12 patients

Administration of influenza virus vaccine

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

This service was performed 38 times for 38 patients

Fee covid-19 vac 13 res

The "Fee Covid-19 Vac 13 Res" service refers to a charge for the 13th dose of the Covid-19 vaccine, typically for individuals requiring additional doses due to specific health conditions. It's crucial to follow your healthcare provider's advice for your health safety.

This service was performed 18 times for 18 patients

Influenza vaccine split virus, preservative free

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

This service was performed 16 times for 16 patients

Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage

The quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.

This service was performed 18 times for 18 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20392097
Accepts Medicare Assignment
YES
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
  • Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
  • Infusion Drugs -
  • Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
  • Oral Anticancer Drugs - FDA anticancer drugs
  • Oral Antiemetic Drugs - FDA antiemetic drugs
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
37D2012832
Facility Type
Pharmacy
Certificate Effective Date
July 28, 2023
Certificate Expiration Date
July 27, 2025
Laboratory Director
SUSAN H. KIM
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Walgreens #03642 to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for WALGREENS #03642

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1952316911
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
29102611292
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 0 + 2 + 6 + 1 + 1 + 2 + 9 + 2 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1952316911 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1639451511 CHRISTINA DAWN ADKINS DPH
Individual
Pharmacist4500 S SHIELDS BLVD
OKLAHOMA CITY, OK 73129
(405) 631-3561
1417203316DR. LUIS ALBERTO PANTOJA PHARM.D.
Individual
Pharmacist4500 S SHIELDS BLVD
OKLAHOMA CITY, OK 73129
(405) 631-3561
1326441973 AUSTIN HARRY
Individual
Pharmacist4500 S SHIELDS BLVD
OKLAHOMA CITY, OK 73129
(405) 631-3561
1225658354 MARK AARON COTTON PHARMD
Individual
Pharmacist4500 S SHIELDS BLVD
OKLAHOMA CITY, OK 73129
(405) 631-3561

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1952316911, enumerated in the NPI registry as an "organization" on July 29, 2006

The provider is located at 4500 S Shields Blvd Oklahoma City, Ok 73129 and the phone number is (405) 631-3561

This medical organization specializes in Pharmacy with taxonomy code 333600000X

The provider might be accepting Accepts: Blue Cross and Blue Shield of Alabama, Blue Cross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The most common procedures or services performed by this practitioner are: Adm sarscv2 30mcg trs-sucr b, Administration of influenza virus vaccine, Fee covid-19 vac 13 res, Influenza vaccine split virus, preservative free and Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage.

The provider's CLIA number is 37D2012832 for a "pharmacy" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on July 29, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.