Walgreens #12862

LBN: Walgreen Co
Walgreens #12862 is an health care organization with primary practice located at 12184 Palmdale Rd , Victorville CA 92392-8538. 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 (760) 561-7009, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
12184 Palmdale Rd Victorville CA 92392-8538
Fax: (760) 955-8025
Website:
Authorized official contact:
Name: Taylor, Kira

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PHY51729 California
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1023431202
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #12862
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 24th, 2014
Last updated Apr 8th, 2022 - about 2 years ago

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 1023431202 NPPES
California MEDICAID 1023431202
California Other 5650355

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