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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
3333600000XPharmacyMP0552373WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15054894OTHERNCPDP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558514448
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 : 5870 WEBSTER RD
Second Line :
City : SUMMERSVILLE
State : WV
Zip : 26651-9105
Country : US
Telephone Number : 304-872-4394
Fax Number : 304-872-5783
Authorized Official
Title or Position : MANAGER
Name : KIRA TAYLOR
Credential :
Telephone Number : 217-709-2351
Provider Enumeration Date : 10/23/2008
Last Update Date : 10/30/2023

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