WALGREENS #05996 – Pharmacy, NPI 1114932001

WALGREENS #05996 is a healthcare provider. based in Lubbock, Texas. specializing in Pharmacy. The organization holds a License No. 20685 (TX). The NPI Number for WALGREENS #05996 is 1114932001

Main info

Organization
Name
WALGREENS #05996
NPI
1114932001
Phone
(806) 748-5209
Address
2417 82ND ST
Authorized Official
JENNIFER PONCE MANAGER
Enumeration Date
29 July 2006
Last Update Date
24 June 2025
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 #05996

  • 2417, 82nd Street, Lubbock, Lubbock County, Texas, 79423, United States

    LUBBOCK, TX 794232300

    Phone: (806) 748-5209

    Type: Location

  • 1901 E VOORHEES ST # MS 790

    DANVILLE, IL 618344515

    Phone: (847) 527-2489

    Fax: (217) 709-2344

    Type: Mailing

  • 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 2025-07-31 (315 days ago).

Enrollment records

1

Earliest due date

2025-07-31

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
O20100930000795OPharmacyTX2025-07-31

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.

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
G0008Administration of influenza virus vaccine171169$0
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count14017$0
90480Admn sarscov2 vacc 1 dose8787$0
90662Influenza vaccine split virus, preservative free8787$0
91320Sarscv2 vac 30mcg trs-suc im8686$0
View full utilization report →

Insurance plans in this area (ZIP 79423)

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Reviews

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Frequently asked questions

Can I use this page to confirm WALGREENS #05996's NPI?
Yes. WALGREENS #05996 is listed with NPI 1114932001 in the public NPI dataset.
Is WALGREENS #05996 listed as active for patients and plans?
The listing shows WALGREENS #05996 as active in the NPI system.
What taxonomy line describes WALGREENS #05996?
For research purposes, treat WALGREENS #05996 as Pharmacy in this dataset. Clinical services aligned with this taxonomy classification.
Does WALGREENS #05996 list a practice location?
Patients near Lubbock, Texas may find WALGREENS #05996 in results; validate coverage separately.
Why does WALGREENS #05996 have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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