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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
3333600000XPharmacy02-1606550OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13674757OTHERNCPDP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417976655
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALGREEN CO
Provider Business Mailing Address
First Line : 1901 E VOORHEES ST
Second Line : MAILSTOP #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 : 20200 VAN AKEN BLVD
Second Line :
City : SHAKER HEIGHTS
State : OH
Zip : 44122-3623
Country : US
Telephone Number : 216-751-4521
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : JENNIFER PONCE
Credential :
Telephone Number : 847-527-2489
Provider Enumeration Date : 07/19/2006
Last Update Date : 09/19/2024

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Directions to “WALGREEN CO ” Practice Location

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