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	PHY45267	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0559382	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548275829
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	:	6701 CARNELIAN ST
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91701-4556
Country	:	US
Telephone Number	:	909-581-1157
Fax Number	:

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

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	04/27/2022

Similar Medicare Providers

1316085475 — DR. CHEONG HO YANG L. AC.
Practice Location Address:

6727 CARNELIAN ST
RANCHO CUCAMONGA, CA
91701-4556

Practice Phone: 909-948-2100
Practice Fax: 909-948-2200

1093091985 — JESSICA DUNCAN PHARM.D.
Practice Location Address:

6701 CARNELIAN ST
RANCHO CUCAMONGA, CA
91701-4556

Practice Phone: 909-581-1157
Practice Fax:

1427334218 — KIM HEHN
Practice Location Address:

6701 CARNELIAN ST
RANCHO CUCAMONGA, CA
91701-4556

Practice Phone: 909-581-1157
Practice Fax: 909-581-1066

1356610760 — DR. MARIEGRACE FERNANDEZ PHARMD
Practice Location Address:

6701 CARNELIAN ST
RANCHO CUCAMONGA, CA
91701-4556

Practice Phone: 909-581-1157
Practice Fax:

1770917601 — DR. ALEXANDER WANG-KEE LI JR. PHARMD
Practice Location Address:

6701 CARNELIAN ST
RANCHO CUCAMONGA, CA
91701-4556

Practice Phone: 909-581-1157
Practice Fax:

1730505777 — DR. ADELINE TOM DDS
Practice Location Address:

6795 CARNELIAN ST
RANCHO CUCAMONGA, CA
91701-4556

Practice Phone: 909-483-3431
Practice Fax: 909-483-2052

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.