WALGREENS #06584 – Pharmacy, NPI 1396750295

WALGREENS #06584 is a healthcare provider. based in Pearland, Texas. specializing in Pharmacy. The organization holds a License No. 22004 (TX). The NPI Number for WALGREENS #06584 is 1396750295

Main info

Organization
Name
WALGREENS #06584
NPI
1396750295
Phone
(281) 412-3305
Address
8430 BROADWAY ST
Authorized Official
JENNIFER PONCE MANAGER
Enumeration Date
29 July 2006
Last Update Date
9 February 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 #06584

  • Broadway Street, Pearland, Brazoria County, Texas, 77581, United States

    PEARLAND, TX 775847883

    Phone: (281) 412-3305

    Fax: (281) 412-2191

    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 2026-05-31 (12 days ago).

Enrollment records

1

Earliest due date

2026-05-31

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
O20100930021158OPharmacyTX2026-05-31

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 count17623$0
91322Sarscov2 vac 50 mcg/0.5ml im125125$0
90480Admn sarscov2 vacc 1 dose125125$0
G0008Administration of influenza virus vaccine116116$0
90662Influenza vaccine split virus, preservative free8181$0
View full utilization report →

Insurance plans in this area (ZIP 77584)

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Reviews

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Frequently asked questions

How do payers reference WALGREENS #06584?
For WALGREENS #06584, use NPI 1396750295 as the unique 10-digit identifier.
Is there an active status for WALGREENS #06584?
For scheduling context, WALGREENS #06584 is shown as active in the registry.
What kind of doctor is WALGREENS #06584?
WALGREENS #06584 is associated with Pharmacy in the directory — Clinical services aligned with this taxonomy classification.
Is WALGREENS #06584 associated with Pearland?
Public fields place WALGREENS #06584 around Pearland, Texas. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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