Walgreens #12105

LBN: Walgreen Co
Walgreens #12105 is an health care organization with primary practice located at 680 E Burleigh Blvd , Tavares FL 32778-2208. 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 (352) 253-0289, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
680 E Burleigh Blvd Tavares FL 32778-2208
Fax: (352) 253-2559
Website:
Authorized official contact:
Name: Taylor, Kira

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PH23847 Florida
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1144466335
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #12105
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 18th, 2008
Last updated Mar 29th, 2022 - about 3 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 1144466335 NPPES
Other 1041110 NCPDP
Other 000726401 NCPDP
MEDICAID 000726400 NCPDP

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