Walgreens #12749

LBN: Walgreen Co
Walgreens #12749 is an health care organization with primary practice located at 900 Eastland Dr , Jefferson City MO 65101-3894. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Clinic Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Walgreen Co can be contacted via phone (573) 556-5615, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
900 Eastland Dr Jefferson City MO 65101-3894
Fax: (573) 556-8749
Website:
Authorized official contact:
Name: Taylor, Kira

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 2010007861 Missouri
Suppliers / Clinic Pharmacy 3336C0002X

Profile Details

NPI number 1255660346
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #12749
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 18th, 2009
Last updated Apr 5th, 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 1255660346 NPPES
Iowa MEDICAID 1255660346
Iowa MEDICAID 606469500
Iowa Other 2638952

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