Organization
WALGREEN CO.
Active
Parent organization
WALGREEN CO.
Other names
Nissan Family Pharmacy
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
608 ENON SPRINGS RD E, SMYRNA, TN 37167-4410
(866) 601-9156
(615) 355-7639
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
3737
TN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4435500
NCPDP
—
Enumeration date
02/19/2007
Last updated
04/08/2022
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