Walgreen Co
NPI 1063936185 · Pharmacy · Mattydale, NY
Enrolled with Medicare as Part B Supplier - Independent Clinical Laboratory · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Walgreen Co is a Pharmacy organization in Mattydale, NY (NPI 1063936185).
Provider details
- NPI number
- 1063936185
- Entity type
- Organization
- Primary specialty
- PharmacySuppliers
- Parent organization
- Walgreens Boots Alliance Inc
- Organization subpart
- Yes
- Authorized official
- Kira Taylor, Manager(217) 709-2351
Specialties & taxonomies
Suppliers
Suppliers
- Community/Retail Pharmacy3336C0003X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Walgreens #19049
Registry dates
- Enumerated
- 2017-07-31
- Last updated
- 2022-06-06
- Certified
- 2022-06-06
Frequently asked questions
- What is Walgreen Co's NPI number?
- Walgreen Co's National Provider Identifier (NPI) is 1063936185, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Walgreen Co?
- Walgreen Co is classified in the NPPES registry as Pharmacy (Suppliers).
- Where is Walgreen Co located?
- Walgreen Co's practice location on file with NPPES is 2616 Brewerton Rd, Mattydale, NY 13211-1202.
- What is Walgreen Co's phone number?
- The practice phone number listed in the NPPES registry for Walgreen Co is (315) 455-5641.
- Does Walgreen Co accept Medicare?
- Walgreen Co is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Walgreen Co?
- The authorized official listed on Walgreen Co's NPPES record is Kira Taylor, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Walgreen Co's NPI active?
- Yes — Walgreen Co's NPI (1063936185) is active in the NPPES registry as of the last update on 2022-06-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.