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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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail Pharmacy
3333600000XPharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14450134OTHERNCPDP

General Provider Information

NPI Number : 1336664499
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 : 103 N SHADY ST
Second Line :
City : MOUNTAIN CITY
State : TN
Zip : 37683-1333
Country : US
Telephone Number : 423-727-5651
Fax Number : 423-727-0148
Authorized Official
Title or Position : MANAGER
Name : KIRA TAYLOR
Credential :
Telephone Number : 217-709-2351
Provider Enumeration Date : 08/10/2017
Last Update Date : 06/03/2022

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Directions to “WALGREEN CO ” Practice Location

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