Walgreens #16404 – Pharmacy, NPI 1306851597

Walgreens #16404 is a healthcare provider. based in Altamonte springs, Florida. specializing in Pharmacy. The organization holds a License No. PH21218 (FL). The NPI Number for Walgreens #16404 is 1306851597

Main info

Organization
Name
Walgreens #16404
NPI
1306851597
Phone
(407) 389-7353
Address
855 W STATE RD 436
Authorized Official
KIRA TAYLOR MANAGER
Enumeration Date
29 July 2006
Last Update Date
6 May 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for Walgreens #16404

  • 855 W STATE RD 436

    ALTAMONTE SPRINGS, FL 327143005

    Phone: (407) 389-7353

    Fax: (407) 389-7356

    Type: Location

  • 1201 W State Road 436

    Altamonte Springs, FL 327142736

    Phone: (407) 389-7350

    Type: Location

  • 875 W State Road 436

    Altamonte Springs, FL 327143005

    Phone: (407) 389-7353

    Fax: (407) 389-7356

    Type: Location

  • 855 W State Rd 436

    Altamonte Springs, FL 327143005

    Phone: (407) 389-7353

    Fax: (407) 389-7356

    Type: Location

  • 885 W STATE ROAD 436

    ALTAMONTE SPRINGS, FL 327143005

    Phone: (407) 389-7353

    Fax: (407) 389-7356

    Type: Location

  • 1901, East Voorhees Street, Danville, Vermilion County, Illinois, 61832, United States

    MS 790

    DANVILLE, IL 618344509

    Phone: (217) 709-2351

    Fax: (217) 709-2344

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20100930024002OPharmacyFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count54255$0
G0008Administration of influenza virus vaccine143142$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage8786$0
90480Admn sarscov2 vacc 1 dose7272$0
91320Sarscv2 vac 30mcg trs-suc im7070$0
View full utilization report →

Insurance plans in this area (ZIP 32714)

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Reviews

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Frequently asked questions

How do I look up Walgreens #16404 by NPI?
Use NPI 1306851597 when you need to reference Walgreens #16404 in forms, claims, or directories.
Is Walgreens #16404's NPI currently valid?
The extract we use shows Walgreens #16404 as active.
What does Walgreens #16404 treat or focus on?
Patients typically see Walgreens #16404 under the specialty Pharmacy. Clinical services aligned with this taxonomy classification.
Where is Walgreens #16404's primary listing?
We display Altamonte Springs, Florida because that is what the record indicates for Walgreens #16404.
What if Altamonte Springs, Florida seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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