Walgreens #12504

LBN: Walgreen Co
Walgreens #12504 is an health care organization with primary practice located at 110 W 10Th St , Metropolis IL 62960-1502. 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 (618) 524-4819, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
110 W 10Th St Metropolis IL 62960-1502
Fax: (618) 524-8959
Website:
Authorized official contact:
Name: Taylor, Kira

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 054.019187 Illinois
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1356579338
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #12504
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 29th, 2009
Last updated Apr 4th, 2022 - about 3 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 1356579338 NPPES
Other 1483522 NCPDP PROVIDER IDENTIFICATION NUMBER

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