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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
3333600000XPharmacy5932LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21933539OTHERNCPDP

General Provider Information

NPI Number : 1568645513
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 : 1415 SAINT CHARLES ST
Second Line :
City : HOUMA
State : LA
Zip : 70360-3964
Country : US
Telephone Number : 985-868-4033
Fax Number : 985-868-4256
Authorized Official
Title or Position : MANAGER
Name : KIRA L TAYLOR
Credential :
Telephone Number : 217-709-2351
Provider Enumeration Date : 12/13/2007
Last Update Date : 11/07/2023

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