Organization
WALGREEN CO
Active
Parent organization
WALGREEN CO
Other names
Nissan Family Pharmacy #12952
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
300 NISSAN DR, CANTON, MS 39046-8562
(601) 407-1545
(601) 407-1550
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
3336C0003X
Community/Retail Pharmacy
Primary
05763 0.26
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2521323
NCPDP
MS
Enumeration date
01/23/2007
Last updated
04/08/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up