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	034045	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5814264	OTHER	NY	NCPCP

General Provider Information

NPI Number	:	1518343813
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	:	290 W MERRICK RD
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11580-5360
Country	:	US
Telephone Number	:	516-612-9121
Fax Number	:	516-612-9122

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

Provider Enumeration Date	:	08/10/2015
Last Update Date	:	06/16/2026

Similar Medicare Providers

1023400330 — CHRISTOPHER KHEMRAJ
Practice Location Address:

290 W MERRICK RD
VALLEY STREAM, NY
11580-5360

Practice Phone: 516-612-9121
Practice Fax:

1801596887 — LORRAINE MOHAN
Practice Location Address:

290 W MERRICK RD
VALLEY STREAM, NY
11580-5360

Practice Phone: 516-612-9121
Practice Fax:

1225073588 — VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC
Practice Location Address:

200 COTTAGE AVE , STE 101
MANTECA, CA
95336-4935

Practice Phone: 209-239-2197
Practice Fax: 209-239-7672

1932154382 — DR. YELENA NUTSKOVSKY DMD
Practice Location Address:

375 W ROUTE 59
SPRING VALLEY, NY
10977-5360

Practice Phone: 845-352-5410
Practice Fax: 845-352-5412

1710067129 — MR. YEFIM KHANIMOV DDS
Practice Location Address:

375 W ROUTE 59 , WHITE HOUSE DENTAL
SPRING VALLEY, NY
10977-5360

Practice Phone: 845-356-3353
Practice Fax:

1225374564 — JURUPA VALLEY PHARMACY INC.
Practice Location Address:

7830 LIMONITE AVE
JURUPA VALLEY, CA
92509-5360

Practice Phone: 951-332-2235
Practice Fax: 951-332-2236

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.