WALGREENS #05876 – Pharmacy, NPI 1912912965

WALGREENS #05876 is a healthcare provider. based in Norfolk, Virginia. specializing in Pharmacy. The organization holds a License No. 201003729 (VA). The NPI Number for WALGREENS #05876 is 1912912965

Main info

Organization
Name
WALGREENS #05876
NPI
1912912965
Phone
(757) 489-5291
Address
115 W LITTLE CREEK RD
Authorized Official
JENNIFER PONCE MANAGER
Enumeration Date
29 July 2006
Last Update Date
2 January 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 #05876

  • 115, West Little Creek Road, Suburban Acres, Norfolk, Virginia, 23505, United States

    NORFOLK, VA 235052512

    Phone: (757) 489-5291

    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 2026-01-31 (132 days ago).

Enrollment records

1

Earliest due date

2026-01-31

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
O20100930088850OPharmacyVA2026-01-31

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 count39245$0
G0008Administration of influenza virus vaccine192191$0
90480Admn sarscov2 vacc 1 dose190190$0
91320Sarscv2 vac 30mcg trs-suc im185185$0
90662Influenza vaccine split virus, preservative free9595$0
View full utilization report →

Insurance plans in this area (ZIP 23505)

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Reviews

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Frequently asked questions

How do I look up WALGREENS #05876 by NPI?
Use NPI 1912912965 when you need to reference WALGREENS #05876 in forms, claims, or directories.
Is WALGREENS #05876 active in the national directory?
WALGREENS #05876's public NPI profile is in an active state.
What field does WALGREENS #05876 work in?
You can think of WALGREENS #05876 as practicing within Pharmacy. Clinical services aligned with this taxonomy classification.
What location metadata exists for WALGREENS #05876?
The page summarizes Norfolk, Virginia for WALGREENS #05876; expand the address list for detail.
How can I contact WALGREENS #05876?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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