Walgreens #19964

LBN: Walgreen Co
Walgreens #19964 is an health care organization with primary practice located at 77-105 Bloomfield Ave , Bloomfield NJ 07003-5985. 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 (973) 259-9290, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
77-105 Bloomfield Ave Bloomfield NJ 07003-5985
Fax: (973) 259-1713
Website:
Authorized official contact:
Name: Taylor, Kira

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 28RS00570900 New Jersey
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1134644826
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #19964
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 3rd, 2017
Last updated Jun 13th, 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 1134644826 NPPES
New Jersey Other 3154034 NCPDP
New Jersey MEDICAID 0611964 NCPDP

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