Walgreens #12756

LBN: Walgreen Co
Walgreens #12756 is an health care organization with primary practice located at 2025 1St Ave Se , Moultrie GA 31788-5155. 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 (229) 890-2776, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
2025 1St Ave Se Moultrie GA 31788-5155
Phone: (229) 890-2776
Fax: (229) 985-3025
Website:
Map and Directions
Authorized official contact:
Name: Taylor, Kira
Phone: (217) 709-2351

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PHRE009932 Georgia
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1457693004
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #12756
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 21st, 2013
Last updated Apr 6th, 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 1457693004 NPPES
Georgia Other 1163308 NCPDP
Georgia MEDICAID 003137212A NCPDP

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