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Organization

WALGREEN CO.

Active
Parent organization
WALGREEN CO.
Other names
Coushatta Family Pharmacy
Organization subpart
Yes

Provider details

NPI number
Legal business name
WALGREEN CO.
Authorized official
MR. KERMIT R CRAWFORD (SENIOR VICE PRESIDENT)
(847) 914-3154
Entity
Organization

Contact information

Practice address
287 PANTHER TRAIL, KINDER, LA 70648
(337) 738-3095
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(217) 554-8786
(217) 554-8546

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
Primary
6189
LA
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1934721
NCPDP
Enumeration date
09/08/2009
Last updated
10/27/2009
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