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	PHY45124	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0559229	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	:	1720093008
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	:	5913 CARSON ST
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90713-3104
Country	:	US
Telephone Number	:	562-429-9120
Fax Number	:	562-429-8340

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	:	04/28/2022

Similar Medicare Providers

1235072810 — CHRISTINA NICOLE SZLANTA
Practice Location Address:

5913 CARSON ST
LAKEWOOD, CA
90713-3104

Practice Phone: 562-429-9120
Practice Fax:

1467721522 — DR. JESSICA E CALVILLO PHARM.D
Practice Location Address:

5913 CARSON ST
LAKEWOOD, CA
90713-3104

Practice Phone: 562-429-9120
Practice Fax:

1104195023 — DANIEL BRIAN QUAN PHARM.D.
Practice Location Address:

5913 CARSON ST
LAKEWOOD, CA
90713-3104

Practice Phone: 562-429-9120
Practice Fax: 562-429-8340

1225308828 — JENNY T PHAM PHARM. D
Practice Location Address:

5913 CARSON ST
LAKEWOOD, CA
90713-3104

Practice Phone: 562-429-9120
Practice Fax: 562-429-8340

1699924217 — MRS. JESSICA LINDSAY DELAUGHTER RN, IBCLC
Practice Location Address:

2464 S CARR CT
LAKEWOOD, CO
80227-3104

Practice Phone: 303-882-8193
Practice Fax:

1477704104 — DR. RAGHAVENDRA OLETY DDS
Practice Location Address:

4180 WOODRUFF AVE
LAKEWOOD, CA
90713-3144

Practice Phone: 562-938-9514
Practice Fax:

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.