Walgreens #09612

LBN: Walgreen Co.
Walgreens #09612 is an health care organization with primary practice located at 700 Bridgeport Ave Ste 101 , Shelton CT 06484-4734. 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 (203) 225-0296, or through Taylor, Kira L via phone (217) 709-2351.

Contact Information

Primary practice address
700 Bridgeport Ave Ste 101 Shelton CT 06484-4734
Fax: (203) 225-0309
Website:
Authorized official contact:
Name: Taylor, Kira L

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PCY.2060 Connecticut
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1255350815
LBN Legal business name Walgreen Co.
DBA Doing business as Walgreens #09612
Authorized official Taylor, Kira L
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 18th, 2006
Last updated Oct 5th, 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 1255350815 NPPES
Connecticut MEDICAID 004261872
Connecticut MEDICAID 004262268 DME
Connecticut Other 0720537

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