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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
13336C0003XCommunity/Retail Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacy7856WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25100312OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629085501
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 : 217-709-2364
Fax Number : 217-709-2344
Provider Business Practice Location Address
First Line : 3233 S 27TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-4349
Country : US
Telephone Number : 414-671-3660
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : VIRGINIA GARZA
Credential :
Telephone Number : 217-709-2364
Provider Enumeration Date : 08/02/2006
Last Update Date : 06/14/2024

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1518237486 — MR. JAMES LUSIAK
Practice Location Address:
3333 S 27TH ST
MILWAUKEE, WI
53215-4349
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Practice Fax: 414-671-2587
1578836268 — MUSTAFA HUSSAINI
Practice Location Address:
3333 S 27TH ST
MILWAUKEE, WI
53215-4349
Practice Phone: 414-671-3660
Practice Fax:
1871741603 — ARTURO MARTINEZ
Practice Location Address:
1571 W MAPLEWOOD CT
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53221-4349
Practice Phone: 414-795-0694
Practice Fax: 414-817-0035

Directions to “WALGREEN CO ” Practice Location

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