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	516	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2800072	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1265447205
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	:	2929 N 60TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68104-3414
Country	:	US
Telephone Number	:	402-551-6151
Fax Number	:	402-556-6389

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

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	04/27/2022

Similar Medicare Providers

1518959295 — DR. BONNIE JEAN LEES MD
Practice Location Address:

8200 DODGE STREET , CHILDREN'S HOSPITAL & MEDICARE CENTER
OMAHA, NE
68114-4113

Practice Phone: 402-955-6140
Practice Fax: 402-955-3398

1639785256 — EMMANUEL S KUVETAKIS
Practice Location Address:

2929 N 60TH ST
OMAHA, NE
68104-3414

Practice Phone: 402-551-6151
Practice Fax: 402-556-6389

1295488872 — JUDE K. KEBEH
Practice Location Address:

2929 N 60TH ST
OMAHA, NE
68104-3414

Practice Phone: 402-551-6151
Practice Fax: 402-556-6389

1164222691 — ANDRE JULES OUEDRAOGO
Practice Location Address:

10507 PRATT PLZ
OMAHA, NE
68134-3414

Practice Phone: 910-527-3453
Practice Fax:

1841188745 — KIMBERLY L BOOTH
Practice Location Address:

1337 S 22ND ST
OMAHA, NE
68108-3414

Practice Phone: 402-249-8698
Practice Fax:

1205710407 — ZOIE MAKENNA LANE
Practice Location Address:

2716 S 134TH AVE
OMAHA, NE
68144-3414

Practice Phone: 712-326-7342
Practice Fax:

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.