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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy	8550042	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5128839	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1043225121
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	:	1305 N CASALOMA DR
Second Line	:
City	:	GRAND CHUTE
State	:	WI
Zip	:	54913-8848
Country	:	US
Telephone Number	:	920-730-8218
Fax Number	:	920-730-8287

Authorized Official
Title or Position	:	MANAGER
Name	:	KIRA TAYLOR
Credential	:
Telephone Number	:	217-709-2351

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	10/30/2023

Similar Medicare Providers

1477833127 — LAURA JASPERSON PHARM.D.
Practice Location Address:

1305 N CASALOMA DR
GRAND CHUTE, WI
54913-8848

Practice Phone: 920-730-8218
Practice Fax:

1841576543 — MR. MARK GORDON PHARMD
Practice Location Address:

1305 N CASALOMA DR
GRAND CHUTE, WI
54913-8848

Practice Phone: 920-730-8218
Practice Fax: 920-730-8287

1164158291 — MADYSON DEWITT
Practice Location Address:

1305 N CASALOMA DR
GRAND CHUTE, WI
54913-8848

Practice Phone: 920-730-8218
Practice Fax:

1548455371 — RIMROCK CHIROPRACTIC LLC
Practice Location Address:

1133 PATTERSON RD STE 3
GRAND JUNCTION, CO
81506-8848

Practice Phone: 970-201-3567
Practice Fax:

1619117710 — MS. SUMMER EARTHSONG NCTMB
Practice Location Address:

1133 PATTERSON RD STE 3
GRAND JUNCTION, CO
81506-8848

Practice Phone: 970-243-1388
Practice Fax: 970-243-1572

1538858857 — ADVANCED PHYSICAL THERAPY & SPORTS MEDICINE SC
Practice Location Address:

5000 W CHAMPION DR
GRAND CHUTE, WI
54913-5000

Practice Phone: 920-560-1123
Practice Fax: 920-202-3535

Directions to “WALGREEN CO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.