Walgreens #04777

LBN: Walgreen Co
Walgreens #04777 is an health care organization with primary practice located at 2525 S Alpine Rd , Rockford IL 61108-7812. 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 (815) 227-9536, or through Taylor, Kira L via phone (217) 709-2351.

Contact Information

Primary practice address
2525 S Alpine Rd Rockford IL 61108-7812
Fax:
Website:
Authorized official contact:
Name: Taylor, Kira L

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 54013930 Illinois
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1235144403
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #04777
Authorized official Taylor, Kira L
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 29th, 2006
Last updated Apr 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 1235144403 NPPES
Wisconsin MEDICAID 33259600
Wisconsin Other 1468859
Wisconsin MEDICAID 362127039047

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