Walgreens #10454

LBN: Walgreen Co
Walgreens #10454 is an health care organization with primary practice located at 1071 N Main St , Manteca CA 95336-3744. 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 (209) 825-5481, or through Taylor, Kira L via phone (217) 709-2351.

Contact Information

Primary practice address
1071 N Main St Manteca CA 95336-3744
Phone: (209) 825-5481
Fax: (209) 825-6998
Website:
Map and Directions
Authorized official contact:
Name: Taylor, Kira L
Phone: (217) 709-2351

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PHY37541 California
Suppliers / Community/Retail Pharmacy 3336C0003X PHY37541 California

Profile Details

NPI number 1245245539
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #10454
Authorized official Taylor, Kira L
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 29th, 2006
Last updated Oct 26th, 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1245245539 NPPES
California MEDICAID PHA375410
California Other 0566642
California MEDICAID 1245245539

Popular Providers