WALGREENS #06404 – Pharmacy, NPI 1336154459
Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for WALGREENS #06404
11204 W STATE ROAD 84
DAVIE, FL 333254021
Phone: (954) 476-0203
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)
Past revalidation due date
Earliest CMS due date was 2024-10-31 (588 days ago).
Enrollment records
1
Earliest due date
2024-10-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100930096527 | O | Pharmacy | FL | 2024-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 1,132 | 115 | $0 |
| G0008 | Administration of influenza virus vaccine | 98 | 98 | $0 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 96 | 96 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 96 | 96 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 62 | 62 | $0 |
Insurance plans in this area (ZIP 33325)
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