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Organization

MED-X CORPORATION

Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
MED-X Drug #15
Organization subpart
Yes

Provider details

NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
MR. ALAN NIELSEN (TREASURER)
(847) 315-3523
Entity
Organization

Contact information

Practice address
15030 S MEMORIAL DR, BIXBY, OK 74008-3706
(918) 366-9410
(918) 366-9415
Mailing address
1901 E VOORHEES, MS 790, DANVILLE, IL 61834-4509
(217) 709-2386
(217) 709-2344

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
22997
OK
333600000X
Pharmacy
22997
OK
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100233260N
OK
01
100246210L
MEDICAID DME
OK
01
3715957
OTHER ID NUMBER-COMMERCIAL NUMBER
01
400522490
MEDCARE FLU
OK
Enumeration date
10/25/2006
Last updated
04/05/2017
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