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1598770596

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
1	291U00000X	Clinical Medical Laboratory
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0003X	Community/Retail Pharmacy
4	333600000X	Pharmacy	2468100	OH

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	3645453	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598770596
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALGREEN CO

Provider Business Mailing Address
First Line	:	1901 E VOORHEES ST
Second Line	:	MAILSTOP #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	:	4605 MONTGOMERY RD
Second Line	:
City	:	NORWOOD
State	:	OH
Zip	:	45212-2607
Country	:	US
Telephone Number	:	513-731-0062
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	:	02/13/2023

Similar Medicare Providers

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1104055110 — DAVID LEE POTTS PHARM.D.
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1477835981 — DR. CHRISTINE ANN HINDERY PHARM.D.
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1982981361 — DR. BRANDON LUBBERS PHARMD
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1003431255 — MEGHAN O'KEEFE PHARMD
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1245205657 — MRS. OLIVIA ANN FERRARI CNP
Practice Location Address:

4605 MONTGOMERY RD , INSIDE WALGREENS
CINCINNATI, OH
45212-2607

Practice Phone: 513-826-5351
Practice Fax: 513-826-5352

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.

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