Walgreens #12522

LBN: Walgreen Co
Walgreens #12522 is an health care organization with primary practice located at 1620 S Broadway Ave , Tyler TX 75701-4260. The organization recently has 4 registered licenses in different health care specialties including Laboratories / Clinical Medical Laboratory, 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 (903) 533-0367, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
1620 S Broadway Ave Tyler TX 75701-4260
Phone: (903) 533-0367
Fax: (903) 533-1063
Website:
Map and Directions
Authorized official contact:
Name: Taylor, Kira
Phone: (217) 709-2351

Health care specialties

SpecialtyCodeLicense #State
Laboratories / Clinical Medical Laboratory 291U00000X
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 26346 Texas
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1982845509
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #12522
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 11th, 2009
Last updated Feb 23rd, 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 1982845509 NPPES
Other 4551645 NCPDP
MEDICAID 466593 NCPDP
MEDICAID 468106 NCPDP

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