MEDICARE: WALGREEN CO

Medicare Provider Information

Scope of Practice

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

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

General Provider Information

NPI Number	:	1285157214
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	:	217-709-2386
Fax Number	:	217-709-2344

Provider Business Practice Location Address
First Line	:	136 SEA ISLAND PKWY STE B
Second Line	:
City	:	BEAUFORT
State	:	SC
Zip	:	29907-1562
Country	:	US
Telephone Number	:	843-522-0707
Fax Number	:	843-522-2733

Authorized Official
Title or Position	:	MANAGER
Name	:	ALYSSA SWEETEN
Credential	:
Telephone Number	:	217-709-2386

Provider Enumeration Date	:	07/21/2017
Last Update Date	:	06/16/2018

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Directions to “WALGREEN CO ” Practice Location

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