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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
13336C0003XCommunity/Retail Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacyPHY44894CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10555031OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750396032
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 : 60 N HIGHLAND SPRINGS AVE
Second Line :
City : BANNING
State : CA
Zip : 92220-3048
Country : US
Telephone Number : 951-845-5984
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 : 04/25/2022

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Practice Fax: 951-845-7845
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1306116868 — DR. DAVID KIEN HO PHARMD
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1225475411 — AMY ANN BALOG PHARM.D
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1982041992 — KENNETH THANG NGUYEN PHARMD
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1447692157 — RONALDA LYNN CHANEY PHARM D
Practice Location Address:
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Practice Fax:

Directions to “WALGREEN CO ” Practice Location

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