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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
3333600000XPharmacy28RS00500000NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
128RS0050000OTHERNJBOARD OF PHARMACY
23135919OTHERNJNCPDP

General Provider Information

NPI Number : 1508381252
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALGREEN CO
Provider Business Mailing Address
First Line : 1901 E VOORHEES ST # MS 790
Second Line :
City : DANVILLE
State : IL
Zip : 61834-4509
Country : US
Telephone Number : 217-709-2386
Fax Number : 217-709-2344
Provider Business Practice Location Address
First Line : 425 S WASHINGTON AVE
Second Line :
City : BERGENFIELD
State : NJ
Zip : 07621-4313
Country : US
Telephone Number : 201-384-1147
Fax Number : 201-384-1625
Authorized Official
Title or Position : MANAGER
Name : ALYSSA SWEETEN
Credential :
Telephone Number : 217-709-2386
Provider Enumeration Date : 08/03/2017
Last Update Date : 06/15/2018

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Directions to “WALGREEN CO ” Practice Location

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