WALGREENS #05734 – Pharmacy, NPI 1114932191

WALGREENS #05734 is a healthcare provider. based in Edinburg, Texas. specializing in Pharmacy. The organization holds a License No. 20303 (TX). The NPI Number for WALGREENS #05734 is 1114932191

Main info

Organization
Name
WALGREENS #05734
NPI
1114932191
Phone
(956) 287-9183
Address
1520 W FREDDY GONZALEZ DR
Authorized Official
JENNIFER PONCE MANAGER
Enumeration Date
29 July 2006
Last Update Date
21 November 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 #05734

  • 1520, West Freddy Gonzalez Drive, Enfield Estates, Altamira West Number 2 Colonia, Edinburg, Hidalgo County, Texas, 78539, United States

    EDINBURG, TX 785395327

    Phone: (956) 287-9183

    Fax: (956) 287-9187

    Type: Location

  • 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

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 2025-12-31 (161 days ago).

Enrollment records

1

Earliest due date

2025-12-31

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
O20100930013225OPharmacyTX2025-12-31

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
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count13819$0
G0008Administration of influenza virus vaccine7979$0
91320Sarscv2 vac 30mcg trs-suc im6060$0
90480Admn sarscov2 vacc 1 dose6060$0
90662Influenza vaccine split virus, preservative free5151$0
View full utilization report →

Insurance plans in this area (ZIP 78539)

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Reviews

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Frequently asked questions

Is there an official ID for WALGREENS #05734 in U.S. healthcare records?
The official identifier for WALGREENS #05734 is NPI 1114932191.
Is WALGREENS #05734 still an active registrant?
WALGREENS #05734 carries an active NPI according to the public dataset.
What kind of doctor is WALGREENS #05734?
WALGREENS #05734 is associated with Pharmacy in the directory — Clinical services aligned with this taxonomy classification.
Where in Texas is WALGREENS #05734 registered?
Use Edinburg, Texas as the headline location for WALGREENS #05734 here.
Does WALGREENS #05734 accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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