Walgreens #10712

LBN: Walgreen Co
Walgreens #10712 is an health care organization with primary practice located at 10320 Main St , Fairfax VA 22030-2410. 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 (703) 591-1025, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
10320 Main St Fairfax VA 22030-2410
Fax: (703) 591-1090
Website:
Authorized official contact:
Name: Taylor, Kira

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 0201004159 Virginia
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1245447390
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #10712
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date May 17th, 2007
Last updated Oct 30th, 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 1245447390 NPPES
Other 4840042 NCPDP
MEDICAID 1245447390 NCPDP
MEDICAID 125447390 DME NCPDP

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