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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
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1528786308
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 : 217-709-2351
Fax Number : 217-709-2344
Provider Business Practice Location Address
First Line : 5190 W 120TH AVE
Second Line :
City : WESTMINSTER
State : CO
Zip : 80020-3332
Country : US
Telephone Number : 303-410-1105
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : KIRA L TAYLOR
Credential :
Telephone Number : 217-709-2351
Provider Enumeration Date : 08/18/2022
Last Update Date : 08/18/2022

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