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	2-13132	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1719218	OTHER	NCPDP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366633570
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	:	2229 S. MAIN ST.
Second Line	:
City	:	FORT SCOTT
State	:	KS
Zip	:	66701-3023
Country	:	US
Telephone Number	:	620-223-2402
Fax Number	:	620-223-4954

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

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	11/06/2023

Similar Medicare Providers

1194005710 — DR. AMANDA KAY TREIBER PHARM D.
Practice Location Address:

2229 S MAIN ST
FORT SCOTT, KS
66701-3023

Practice Phone: 620-223-2402
Practice Fax: 620-223-4954

1982973061 — LOTANNA CHRISTOPHER OKEKE II RPH
Practice Location Address:

2229 S MAIN ST
FORT SCOTT, KS
66701-3023

Practice Phone: 620-223-2402
Practice Fax:

1891049920 — SYBILLE SCHELLACK
Practice Location Address:

2229 S MAIN ST
FORT SCOTT, KS
66701-3023

Practice Phone: 620-223-2402
Practice Fax: 620-223-4921

1467064006 — DAVID ALAN DUNSHEE RPH
Practice Location Address:

2229 S MAIN ST
FORT SCOTT, KS
66701-3023

Practice Phone: 620-223-2402
Practice Fax: 620-223-4954

1689672750 — PROSTHETIC DESIGN INC
Practice Location Address:

2665 SCOTT AVE STE E
SAINT LOUIS, MO
63103-3023

Practice Phone: 314-535-5359
Practice Fax: 314-535-5488

1982392510 — PROSTHETIC DESIGN INC
Practice Location Address:

2665 SCOTT AVE STE E
SAINT LOUIS, MO
63103-3023

Practice Phone: 314-535-5359
Practice Fax: 314-535-5488

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.