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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
3333600000XPharmacy60004082AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11528338OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215942347
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 : 7769 W STATE ROUTE 66
Second Line :
City : NEWBURGH
State : IN
Zip : 47630-2544
Country : US
Telephone Number : 812-853-5339
Fax Number : 812-853-2075
Authorized Official
Title or Position : MANAGER
Name : KIRA L TAYLOR
Credential :
Telephone Number : 217-709-2351
Provider Enumeration Date : 07/29/2006
Last Update Date : 06/15/2026

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1578176913 — CHRISTIAN LYONS PHARMD
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Directions to “WALGREEN CO ” Practice Location

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