WALGREENS #06704 – Pharmacy, NPI 1891702825

WALGREENS #06704 is a healthcare provider. based in Palm bay, Florida. specializing in Pharmacy. The organization holds a License No. PH11065 (FL). The NPI Number for WALGREENS #06704 is 1891702825

Main info

Organization
Name
WALGREENS #06704
NPI
1891702825
Phone
(321) 728-4055
Address
175 MALABAR RD NW
Authorized Official
KIRA L TAYLOR MANAGER
Enumeration Date
2 August 2006
Last Update Date
10 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

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Provider Addresses for WALGREENS #06704

  • Malabar Road / Hurley Boulevard (Northwest Corner), Malabar Road Southwest, Southwest Palm Bay, Palm Bay, Brevard County, Florida, 32907, United States

    PALM BAY, FL 329072944

    Phone: (321) 728-4055

    Type: Location

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

    MAILSTOP #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
O20100930035943OPharmacyFLTBD

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 count52461$0
G0008Administration of influenza virus vaccine9694$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage6666$0
90480Admn sarscov2 vacc 1 dose6363$0
91320Sarscv2 vac 30mcg trs-suc im6161$0
View full utilization report →

Insurance plans in this area (ZIP 32907)

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Reviews

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Frequently asked questions

What federal number belongs to WALGREENS #06704?
The federal identifier for WALGREENS #06704 is NPI 1891702825.
Does this profile mean WALGREENS #06704 is currently active?
Yes — WALGREENS #06704 appears active in the national provider directory.
What field does WALGREENS #06704 work in?
You can think of WALGREENS #06704 as practicing within Pharmacy. Clinical services aligned with this taxonomy classification.
Where does public data place WALGREENS #06704?
The snapshot lists Palm Bay, Florida for WALGREENS #06704; download NPPES for the complete set.
Is WALGREENS #06704 a real provider?
This page reflects official NPPES data for NPI 1891702825. Always confirm identity and privileges with the practice and licensing boards.

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