WALGREENS #03419 – Pharmacy, NPI 1124035134

WALGREENS #03419 is a healthcare provider. based in Danville, Illinois. specializing in Pharmacy. The organization holds a License No. 16433 (TX). The NPI Number for WALGREENS #03419 is 1124035134

Main info

Organization
Name
WALGREENS #03419
NPI
1124035134
Phone
(847) 527-2489
Address
1901 E VOORHEES ST
Authorized Official
JENNIFER PONCE MANAGER
Enumeration Date
2 August 2006
Last Update Date
27 March 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness90
Years active:19State licenses:1Digital endpoints

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Provider Addresses for WALGREENS #03419

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

    MS 790

    DANVILLE, IL 618344515

    Phone: (847) 527-2489

    Fax: (217) 709-2344

    Type: Mailing

  • 4790, Lexington Boulevard, Missouri City, Fort Bend County, Texas, 77459, United States

    MISSOURI CITY, TX 774592800

    Phone: (281) 499-5257

    Fax: (281) 499-3772

    Type: Location

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)

Revalidation due soon

Earliest CMS due date is 2026-06-30 (20 days away).

Enrollment records

1

Earliest due date

2026-06-30

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
O20100930038231OPharmacyTX2026-06-30

What to do next

  • Confirm the due date on the CMS Revalidation Lookup Tool.
  • Complete revalidation in PECOS before the published due date.
  • If you have multiple enrollment records, revalidate each one on its own schedule.

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 count78289$0
G0008Administration of influenza virus vaccine196196$0
90662Influenza vaccine split virus, preservative free125125$0
90480Admn sarscov2 vacc 1 dose107107$0
91320Sarscv2 vac 30mcg trs-suc im103103$0
View full utilization report →

Insurance plans in this area (ZIP 61834)

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Reviews

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Frequently asked questions

What number should I use to identify WALGREENS #03419 for billing?
Administrative and clinical systems typically use NPI 1124035134 for WALGREENS #03419.
Is WALGREENS #03419's NPI status active today?
Active status means WALGREENS #03419's NPI record is not deactivated in the public file.
What services align with WALGREENS #03419's listing?
WALGREENS #03419's public classification highlights Pharmacy. Clinical services aligned with this taxonomy classification.
Which community is linked to WALGREENS #03419?
WALGREENS #03419 shows a connection to Danville, Illinois in registry-derived data.
Can I export WALGREENS #03419's record?
You can download the official NPPES record; we summarize key fields for readability.

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