Walgreens #11442

LBN: Walgreen Co
Walgreens #11442 is an health care organization with primary practice located at 310 S Lake Ave , Pasadena CA 91101-3537. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Walgreen Co can be contacted via phone (626) 583-8066, or through Taylor, Kira L via phone (217) 709-2351.

Contact Information

Primary practice address
310 S Lake Ave Pasadena CA 91101-3537
Fax: (626) 583-8072
Website:
Authorized official contact:
Name: Taylor, Kira L

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PHY48831 California
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1023206463
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #11442
Authorized official Taylor, Kira L
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 11th, 2007
Last updated Oct 27th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023206463 NPPES
California MEDICAID 1023206463
California Other 5628500
California MEDICAID PHA488310

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