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NPI Code Detail

MEDICARE: WALGREEN CO.

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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail Pharmacy
3333600000XPharmacyPHRE009406GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11156391OTHEROTHER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538356399
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 : 634 N CHURCH ST
Second Line :
City : THOMASTON
State : GA
Zip : 30286-3612
Country : US
Telephone Number : 706-647-4000
Fax Number : 706-647-4020
Authorized Official
Title or Position : MANAGER
Name : KIRA L TAYLOR
Credential :
Telephone Number : 217-709-2351
Provider Enumeration Date : 09/26/2007
Last Update Date : 11/01/2023

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Directions to “WALGREEN CO. ” Practice Location

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