Walgreens #15822

LBN: Walgreen Co
Walgreens #15822 is an health care organization with primary practice located at 1142 N Desloge Dr , Desloge MO 63601-2937. 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 (573) 431-2242, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
1142 N Desloge Dr Desloge MO 63601-2937
Fax: (573) 431-4799
Website:
Authorized official contact:
Name: Taylor, Kira

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 2017006078 Missouri
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1336495373
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #15822
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 27th, 2012
Last updated May 3rd, 2022 - about 3 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 1336495373 NPPES
Missouri MEDICAID 600003307
Missouri Other 2640589

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