Walgreens #02490

LBN: Walgreen Co
Walgreens #02490 is an health care organization with primary practice located at 401 Belt Line Rd , Collinsville IL 62234-4406. 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 (618) 344-6639, or through Taylor, Kira L via phone (217) 709-2351.

Contact Information

Primary practice address
401 Belt Line Rd Collinsville IL 62234-4406
Fax: (618) 344-6041
Website:
Authorized official contact:
Name: Taylor, Kira L

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 54012034 Illinois
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1154336311
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #02490
Authorized official Taylor, Kira L
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 29th, 2006
Last updated Nov 2nd, 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 1154336311 NPPES
Illinois MEDICAID 362127039333
Illinois Other 1465803

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