Walgreens #12869 – Pharmacy, NPI 1639477268

Walgreens #12869 is a healthcare provider. based in Danville, Illinois. specializing in Pharmacy. The organization holds a License No. DS89777 (MA). The NPI Number for Walgreens #12869 is 1639477268

Main info

Organization
Name
Walgreens #12869
NPI
1639477268
Phone
(217) 709-2351
Address
1901 E VOORHEES ST
Authorized Official
KIRA TAYLOR MANAGER
Enumeration Date
7 March 2011
Last Update Date
8 April 2022
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness80
Years active:15State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for Walgreens #12869

  • 1901 E VOORHEES ST

    MS #790

    DANVILLE, IL 618344509

    Phone: (217) 709-2351

    Fax: (217) 709-2344

    Type: Mailing

  • 296 BUFFINTON ST

    SOMERSET, MA 027264528

    Phone: (508) 674-0342

    Fax: (508) 675-3202

    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: 2011-08-30

PECOS data refreshed: 2026-06-15

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
O20110830000107OPharmacyMATBD

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 count2,048201$0
G0008Administration of influenza virus vaccine396396$0
90480Admn sarscov2 vacc 1 dose392392$0
91320Sarscv2 vac 30mcg trs-suc im380380$0
90662Influenza vaccine split virus, preservative free251251$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 unique ID ties claims to Walgreens #12869?
NPI 1639477268 is assigned to Walgreens #12869 under the national enumeration system.
Is Walgreens #12869 active in the national directory?
Walgreens #12869's public NPI profile is in an active state.
Does Walgreens #12869 list a primary specialty?
If you are matching referrals, note Pharmacy for Walgreens #12869. Clinical services aligned with this taxonomy classification.
What location metadata exists for Walgreens #12869?
The page summarizes Danville, Illinois for Walgreens #12869; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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