Walgreens #10604

LBN: Walgreen Co
Walgreens #10604 is an health care organization with primary practice located at 1625 S Meridian Rd , Meridian ID 83642-9355. 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) 319-0600, or through Taylor, Kira L via phone (217) 709-2351.

Contact Information

Primary practice address
1625 S Meridian Rd Meridian ID 83642-9355
Fax: (208) 319-0606
Website:
Authorized official contact:
Name: Taylor, Kira L

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 38484RP Idaho
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1154503837
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #10604
Authorized official Taylor, Kira L
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 4th, 2007
Last updated Nov 1st, 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 1154503837 NPPES
Idaho Other 1307823 NCPDP
Idaho MEDICAID 808028100 DME NCPDP
Idaho MEDICAID 807955800 NCPDP

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