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	3845	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4436235	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467469478
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	:	2960 CANADA RD
Second Line	:
City	:	LAKELAND
State	:	TN
Zip	:	38002-9712
Country	:	US
Telephone Number	:	901-379-2102
Fax Number	:

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	05/12/2022

Similar Medicare Providers

1265744403 — MS. SUZANNE M SWETT PHARMACIST
Practice Location Address:

2960 CANADA RD
LAKELAND, TN
38002-9712

Practice Phone: 901-379-2102
Practice Fax:

1134112766 — MARSHA V LEE M.D.
Practice Location Address:

8950 HWY 64 , SUITE 116
LAKELAND, TN
38002

Practice Phone: 901-383-7170
Practice Fax: 901-388-6478

1558358788 — DR. ANGELA MICHELLE CULBRETH M.D.
Practice Location Address:

2961 CANADA RD STE 105
LAKELAND, TN
38002-4893

Practice Phone: 901-388-0115
Practice Fax: 901-385-7924

1649233206 — TOTAL RENAL CARE INC
Practice Location Address:

9160 HIGHWAY 64
LAKELAND, TN
38002-4766

Practice Phone: 901-380-1511
Practice Fax: 901-380-5624

1235176041 — DR. LUPO TANJUAKIO CARLOTA JR. M.D.
Practice Location Address:

9749 GREEN SPRUCE DR
LAKELAND, TN
38002-9341

Practice Phone: 901-821-8595
Practice Fax:

1659481448 — MRS. RESA SATURDAY BARAWID P.T.
Practice Location Address:

9160 HIGHWAY 64 , SUITE 3
LAKELAND, TN
38002-4766

Practice Phone: 901-388-4474
Practice Fax: 901-388-4486

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.