Walgreens #12396
LBN: Walgreen Co
Walgreens #12396 is an health care organization with primary practice located at 505 W Raab Rd , Normal IL 61761-1007. 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 (309) 454-7347, or through Taylor, Kira via phone (217) 709-2351.
Contact Information
Primary practice address
505 W Raab Rd
Normal IL 61761-1007
Phone: (309) 454-7347
Fax: (309) 454-3915
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | 54011043 | Illinois |
| Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
| NPI number | 1235144478 |
|---|---|
| LBN Legal business name | Walgreen Co |
| DBA Doing business as | Walgreens #12396 |
| Authorized official | Taylor, Kira |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Jul 29th, 2006 |
| Last updated | Apr 1st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235144478 | NPPES |
| Other | 1460485 | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| MEDICAID | 362127039410 | OTHER ID NUMBER-COMMERCIAL NUMBER |
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