Walgreens #15973

LBN: Walgreen Co
Walgreens #15973 is an health care organization with primary practice located at 1604 W Broadway St , Idaho Falls ID 83402-3048. 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) 522-4655, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
1604 W Broadway St Idaho Falls ID 83402-3048
Fax: (208) 522-6670
Website:
Authorized official contact:
Name: Taylor, Kira

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 37895RP Idaho
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1093996399
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #15973
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 15th, 2007
Last updated May 4th, 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 1093996399 NPPES
Idaho MEDICAID 807971500 DME
Idaho Other 1307811
Idaho MEDICAID 807911900

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