Organization
WALGREEN CO
Active
Parent organization
WALGREEN CO
Other names
WALGREENS #06212
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREEN CO
Authorized official
KIRA L TAYLOR (MANAGER)
(217) 709-2351
Entity
Organization
Contact information
Practice address
824 W POPLAR AVE, COLLIERVILLE, TN 38017-2579
(901) 853-3714
Mailing address
1901 E VOORHEES ST, MAILSTOP #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
C1813
TN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030541
—
MS
05
—
1454861
—
TN
01
—
4423264
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/29/2006
Last updated
05/04/2022
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