Walgreens #03079

LBN: Walgreen Co
Walgreens #03079 is an health care organization with primary practice located at 3090 W New Haven Ave , West Melbourne FL 32904-3658. 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 (321) 727-8453, or through Taylor, Kira L via phone (217) 709-2351.

Contact Information

Primary practice address
3090 W New Haven Ave West Melbourne FL 32904-3658
Phone: (321) 727-8453
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Taylor, Kira L
Phone: (217) 709-2351

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PH0012818 Florida
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1669487971
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #03079
Authorized official Taylor, Kira L
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 29th, 2006
Last updated Oct 31st, 2023 - 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 1669487971 NPPES
Florida MEDICAID 102728001 DME
Florida Other 1071632
Florida MEDICAID 102728000

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