Walgreens #12307

LBN: Walgreen Co
Walgreens #12307 is an health care organization with primary practice located at 120 S Bishop Ave , Rolla MO 65401-4215. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Walgreen Co can be contacted via phone (573) 426-3338, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
120 S Bishop Ave Rolla MO 65401-4215
Fax: (573) 426-3168
Website:
Authorized official contact:
Name: Taylor, Kira

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 2009012845 Missouri
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1235372749
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #12307
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 14th, 2009
Last updated Mar 30th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235372749 NPPES
Missouri Other 1235372749 MO DME
Missouri Other 2638546 MO DME
Missouri MEDICAID 606421105 MO DME

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