MEDICARE: WALGREEN CO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy	PHY22433	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0575184	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1013922301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALGREEN CO

Provider Business Mailing Address
First Line	:	1901 E VOORHEES ST # MS 790
Second Line	:
City	:	DANVILLE
State	:	IL
Zip	:	61834-4509
Country	:	US
Telephone Number	:	217-709-2351
Fax Number	:	217-709-2344

Provider Business Practice Location Address
First Line	:	1795 E CAPITOL EXPY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1561
Country	:	US
Telephone Number	:	408-238-5890
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	KIRA L TAYLOR
Credential	:
Telephone Number	:	217-709-2351

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	10/27/2023

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1063412054 — DR. JOLLY SHAH DDS
Practice Location Address:

1761 E CAPITOL EXPY
SAN JOSE, CA
95121-1561

Practice Phone: 408-223-2500
Practice Fax: 408-223-5525

1306967989 — DR. LAURA C.H. LAM D.D.S.
Practice Location Address:

1761 E CAPITOL EXPY
SAN JOSE, CA
95121-1561

Practice Phone: 408-223-2500
Practice Fax: 408-223-5525

1215262225 — LOGESH SWAYAMPRAKASAM
Practice Location Address:

1761 E CAPITOL EXPY
SAN JOSE, CA
95121-1561

Practice Phone: 408-484-3891
Practice Fax:

1609176676 — MRS. TRANG PHUONG NGUYEN PHARMACIST
Practice Location Address:

1771 E CAPITOL EXPY
SAN JOSE, CA
95121-1561

Practice Phone: 408-238-1770
Practice Fax: 408-238-7821

1073813762 — MRS. KIM-OANH VU PHARM.D.
Practice Location Address:

1771 E CAPITOL EXPY
SAN JOSE, CA
95121-1561

Practice Phone: 408-238-1770
Practice Fax: 408-238-7821

Directions to “WALGREEN CO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.