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	PH1307	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2967442	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760499644
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	:	6001 W CHEYENNE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-4205
Country	:	US
Telephone Number	:	702-396-0917
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	KIRA L TAYLOR
Credential	:
Telephone Number	:	217-709-2351

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	04/21/2022

Similar Medicare Providers

1790785590 — MARQUIS COMPANIES I, INC
Practice Location Address:

6021 W CHEYENNE AVE
LAS VEGAS, NV
89108-4205

Practice Phone: 702-658-9494
Practice Fax: 702-658-9419

1609973569 — JOYCE MICHELE LENTZ
Practice Location Address:

6021 W CHEYENNE AVE
LAS VEGAS, NV
89108-4205

Practice Phone: 702-396-1437
Practice Fax: 702-396-1443

1922195114 — SWAN DIALYSIS SERVICES, LLC
Practice Location Address:

6021 W CHEYENNE AVE
LAS VEGAS, NV
89108-4205

Practice Phone: 702-396-0220
Practice Fax: 702-396-8640

1265651673 — NICOLE DANIELLE DUBOIS OTR
Practice Location Address:

6021 W CHEYENNE AVE
LAS VEGAS, NV
89108-4205

Practice Phone: 702-346-1400
Practice Fax:

1841573276 — STANLEY WONG RPH
Practice Location Address:

6001 W CHEYENNE AVE
LAS VEGAS, NV
89108-4205

Practice Phone: 702-396-0917
Practice Fax:

1063796647 — JOHNNY CHUNG-YIN CHAN
Practice Location Address:

6001 W CHEYENNE AVE
LAS VEGAS, NV
89108-4205

Practice Phone: 702-396-0917
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 © 2007-2025 (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.