WALGREENS #07964 – Pharmacy, NPI 1700891892

WALGREENS #07964 is a healthcare provider. based in Victoria, Texas. specializing in Pharmacy. The organization holds a License No. 24154 (TX). The NPI Number for WALGREENS #07964 is 1700891892

Main info

Organization
Name
WALGREENS #07964
NPI
1700891892
Phone
(361) 576-5238
Address
5204 N NAVARRO ST
Authorized Official
KIRA L TAYLOR MANAGER
Enumeration Date
29 July 2006
Last Update Date
27 February 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for WALGREENS #07964

  • 5204, North Navarro Street, Victoria, Victoria County, Texas, 77904, United States

    VICTORIA, TX 779041703

    Phone: (361) 576-5238

    Fax: (361) 578-5614

    Type: Location

  • 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: 2026-06-15

Medicare revalidation (CMS due date list)

Revalidation due soon

Earliest CMS due date is 2026-07-31 (45 days away).

Enrollment records

1

Earliest due date

2026-07-31

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
O20100930034492OPharmacyTX2026-07-31

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 count43360$0
G0008Administration of influenza virus vaccine306304$0
91322Sarscov2 vac 50 mcg/0.5ml im244244$0
90480Admn sarscov2 vacc 1 dose244244$0
90662Influenza vaccine split virus, preservative free180180$0
View full utilization report →

Insurance plans in this area (ZIP 77904)

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Reviews

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Frequently asked questions

Does WALGREENS #07964 have a public NPI I can cite?
Public records show WALGREENS #07964 under NPI 1700891892.
Is WALGREENS #07964's NPI status active today?
Active status means WALGREENS #07964's NPI record is not deactivated in the public file.
What services align with WALGREENS #07964's listing?
WALGREENS #07964's public classification highlights Pharmacy. Clinical services aligned with this taxonomy classification.
Is WALGREENS #07964 tied to Victoria, Texas?
If you are local to Victoria, Texas, WALGREENS #07964 may be relevant to your search.
Why is information missing for WALGREENS #07964?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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