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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
3333600000XPharmacy

General Provider Information

NPI Number : 1790464329
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALGREEN CO.
Provider Business Mailing Address
First Line : 1901 E VOORHEES ST # 790
Second Line :
City : DANVILLE
State : IL
Zip : 61834-4509
Country : US
Telephone Number : 217-709-2351
Fax Number :
Provider Business Practice Location Address
First Line : 388 BERT KOUNS INDUSTRIAL LOOP
Second Line :
City : SHREVEPORT
State : LA
Zip : 71106-8123
Country : US
Telephone Number : 318-687-7558
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : KIRA L TAYLOR
Credential :
Telephone Number : 217-709-2351
Provider Enumeration Date : 07/12/2023
Last Update Date : 09/08/2023

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Directions to “WALGREEN CO. ” Practice Location

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