Walgreens #12821

LBN: Walgreen Co
Walgreens #12821 is an health care organization with primary practice located at 1114 S Main St , Maryville MO 64468-2602. 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 (660) 562-2157, or through Sweeten, Alyssa via phone (217) 709-2386.

Contact Information

Primary practice address
1114 S Main St Maryville MO 64468-2602
Fax:
Website:
Authorized official contact:
Name: Sweeten, Alyssa

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 2009030178 Missouri
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1407088800
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #12821
Authorized official Sweeten, Alyssa
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 18th, 2009
Last updated Apr 8th, 2019 - about 5 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 1407088800 NPPES
Missouri Other 2638801 NCPDP
Missouri MEDICAID 606443604 NCPDP

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