Organization
WALGREEN CO.
Active
Parent organization
WALGREEN CO.
Other names
Walgreens #12424
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREEN CO.
Authorized official
KIRA TAYLOR (MANAGER)
(217) 709-2351
Entity
Organization
Contact information
Practice address
9650 UNIVERSAL BLVD STE 133, ORLANDO, FL 32819-9383
(407) 956-8453
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(217) 709-2351
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PH24437
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001901700
—
FL
01
—
001901701
MEDICAID DME
FL
01
—
1050981
NCPDP
—
Enumeration date
11/24/2009
Last updated
04/01/2022
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