Walgreens #12552

LBN: Walgreen Co
Walgreens #12552 is an health care organization with primary practice located at 3805 S Nova Rd , Port Orange FL 32129-4201. 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 (386) 756-0776, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
3805 S Nova Rd Port Orange FL 32129-4201
Fax: (386) 760-3827
Website:
Authorized official contact:
Name: Taylor, Kira

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PH0008347 Florida
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1346256732
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #12552
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 31st, 2006
Last updated Apr 4th, 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 1346256732 NPPES
Florida MEDICAID 105100801 DME
Florida Other 1046968
Florida MEDICAID 105100800

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