NPI Code Details Logo

NPI 1477992485

NPI 1477992485 : WALGREEN CO : ROCKVILLE, MD

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1477992485
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    WALGREEN CO 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/24/2013
-----------------------------------------------------
    Last Update Date     |    04/26/2022
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    430 HUNGERFORD DR 
-----------------------------------------------------
    City                 |    ROCKVILLE
-----------------------------------------------------
    State                |    MD
-----------------------------------------------------
    Zip                  |    20850-4119
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    240-314-0343
-----------------------------------------------------
    Fax                  |    240-314-0532
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1901 E VOORHEES ST MS 790
-----------------------------------------------------
    City                 |    DANVILLE
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    61834-4509
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    217-709-2351
-----------------------------------------------------
    Fax                  |    217-709-2344
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    MANAGER
-----------------------------------------------------
    Name                 |     KIRA  TAYLOR 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    217-709-2351
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    332B00000X
-----------------------------------------------------
    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    3336C0003X
-----------------------------------------------------
    Taxonomy Name        |    Community/Retail Pharmacy
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    333600000X
-----------------------------------------------------
    Taxonomy Name        |    Pharmacy
-----------------------------------------------------
    License Number       |    P06783
-----------------------------------------------------
    License Number State |    MD
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.