Walgreens #11622

LBN: Walgreen Co
Walgreens #11622 is an health care organization with primary practice located at 1725 1St St , Idaho Falls ID 83401-4306. 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 (208) 419-4684, or through Taylor, Kira L via phone (217) 709-2351.

Contact Information

Primary practice address
1725 1St St Idaho Falls ID 83401-4306
Fax: (208) 419-4690
Website:
Authorized official contact:
Name: Taylor, Kira L

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 38585RP Idaho
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1023281656
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #11622
Authorized official Taylor, Kira L
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 3rd, 2008
Last updated Nov 1st, 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 1023281656 NPPES
Idaho MEDICAID 808108200 DME
Idaho MEDICAID 808073100
Idaho Other 1307885

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