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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
23336C0003XCommunity/Retail Pharmacy
3332B00000XDurable Medical Equipment & Medical Supplies
4333600000XPharmacy25053TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14541264OTHERNCPDP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619053964
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 : 4305 N CONWAY AVE
Second Line :
City : PALMHURST
State : TX
Zip : 78573-1372
Country : US
Telephone Number : 956-519-7523
Fax Number : 956-519-7495
Authorized Official
Title or Position : MANAGER
Name : KIRA L TAYLOR
Credential :
Telephone Number : 217-709-2351
Provider Enumeration Date : 10/30/2006
Last Update Date : 02/23/2023

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Directions to “WALGREEN CO. ” Practice Location

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