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Provider Information for 1548520844


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WALGREEN CO

Other Names:  
Doing Business As: 
WALGREENS #15109

Organization Subpart: YES

NPI: 1548520844
Last Updated: 2022-04-26
Certification Date: 2022-04-26

Details

NameValue
NPI1548520844
Enumeration Date2012-05-21
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: KIRA TAYLOR
Title: Manager
Phone: 2177092351
Mailing Address 1901 E VOORHEES ST
MS #790
DANVILLE, IL 61834-4509
United States

Phone: 217-709-2351 | Fax:217-709-2344
 
Primary Practice Address 4327 JEFFERSON HWY
JEFFERSON, LA 70121-1519
United States

Phone: 504-731-1431 | Fax:504-731-7113
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)LA1936307NCPDP
MEDICAIDLA2201522
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 3336C0003X - Pharmacy - Community/Retail Pharmacy
No 332B00000X - Durable Medical Equipment & Medical Supplies
Yes 333600000X - Pharmacy LAPHY.006580-RC