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Provider Information for 1730194077


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WALGREEN CO

Other Names:  
Doing Business As: 
WALGREENS #03589

Organization Subpart: YES

NPI: 1730194077
Last Updated: 2023-10-27
Certification Date: 2023-10-27

Details

NameValue
NPI1730194077
Enumeration Date2006-07-29
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: KIRA L TAYLOR
Title: MANAGER
Phone: 2177092351
Mailing Address 1901 E VOORHEES ST
MAIL STOP 790
DANVILLE, IL 61834-4509
United States

Phone: 217-709-2351 | Fax:217-709-2344
 
Primary Practice Address 5870 S KIPLING PKWY
LITTLETON, CO 80127-2070
United States

Phone: 303-973-4400 | Fax:303-948-2239
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDMT0214526
MEDICAIDCO03935350
Other (non-Medicare)0609416Other ID Number-Commercial Number
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 332B00000X - Durable Medical Equipment & Medical Supplies
No 333600000X - Pharmacy CO790000020
Yes 3336C0003X - Pharmacy - Community/Retail Pharmacy