Organization
WALGREEN CO.
Active
Parent organization
WALGREEN CO.
Other names
Walgreens #13119
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREEN CO.
Authorized official
MR. KERMIT R CRAWFORD (SENIOR VICE PRESIDENT)
(217) 554-8964
Entity
Organization
Contact information
Practice address
843 WAINEE ST, SUITE 109, LAHAINA, HI 96761-1685
(808) 661-3119
Mailing address
1901 E VOORHEES ST, MS 720, DANVILLE, IL 61834-4509
(217) 554-8964
(217) 554-8546
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHY-760
HI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1240213
NCPDP
—
05
—
62859701
—
HI
Enumeration date
10/02/2008
Last updated
03/06/2009
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