Healthcare Provider Details
I. General information
NPI: 1639698640
Provider Name (Legal Business Name): WALGREEN CO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2017
Last Update Date: 07/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1800 E FRANKLIN ST
CHAPEL HILL NC
27514
US
IV. Provider business mailing address
1901 E VOORHEES ST # MS 790
DANVILLE IL
61834-4509
US
V. Phone/Fax
- Phone: 919-929-1178
- Fax: 919-942-4072
- Phone: 217-709-2386
- Fax: 217-709-2344
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
ALYSSA
SWEETEN
Title or Position: MANAGER
Credential:
Phone: 217-709-2386