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	P07765	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2141505	OTHER	MD	NCPDP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346765815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALGREEN CO

Provider Business Mailing Address
First Line	:	1901 E VOORHEES ST
Second Line	:	MS 790
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	:	92 SOUDER RD
Second Line	:
City	:	BRUNSWICK
State	:	MD
Zip	:	21716-1245
Country	:	US
Telephone Number	:	301-834-8100
Fax Number	:	301-834-4481

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

Provider Enumeration Date	:	08/07/2017
Last Update Date	:	05/27/2022

Similar Medicare Providers

1316942626 — MR. WILLIAM HARRY GILBERT JR. MPT
Practice Location Address:

70 SOUDER RD
BRUNSWICK, MD
21716-1245

Practice Phone: 301-834-6898
Practice Fax: 301-834-6595

1942406541 — DR. BENJAMIN WEISER D.D.S.
Practice Location Address:

64 SOUDER RD
BRUNSWICK, MD
21716-1245

Practice Phone: 301-834-6700
Practice Fax: 301-834-5225

1225344336 — ATTA PANYIN KESSE PHARM.D,MBA
Practice Location Address:

92 SOUDER RD
BRUNSWICK, MD
21716-1245

Practice Phone: 301-834-8100
Practice Fax: 301-834-4481

1932418241 — DICKSON C NWOSU RPH
Practice Location Address:

92 SOUDER RD
BRUNSWICK, MD
21716-1245

Practice Phone: 301-834-8100
Practice Fax:

1902190093 — BRUNSWICK PHYSICAL THERAPY LLC
Practice Location Address:

70 SOUDER RD
BRUNSWICK, MD
21716-1245

Practice Phone: 301-834-6898
Practice Fax: 301-834-6595

1790046845 — MOHAMED ALIYU BARRIE PHARMD
Practice Location Address:

92 SOUDER RD
BRUNSWICK, MD
21716-1245

Practice Phone: 301-834-8100
Practice Fax: 301-834-4481

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.