Walgreens #10467

LBN: Walgreen Co
Walgreens #10467 is an health care organization with primary practice located at 1236 N Waterman Ave , San Bernardino CA 92404-5311. 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 (909) 885-7146, or through Garza, Virginia via phone (217) 709-2364.

Contact Information

Primary practice address
1236 N Waterman Ave San Bernardino CA 92404-5311
Phone: (909) 885-7146
Fax: (909) 889-3978
Website:
Map and Directions
Authorized official contact:
Name: Garza, Virginia
Phone: (217) 709-2364

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PHY48853 California
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1417149089
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #10467
Authorized official Garza, Virginia
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 16th, 2007
Last updated Jun 5th, 2024 - about 5 months 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 1417149089 NPPES
California MEDICAID PHA488530
California Other 5627902
California MEDICAID 1417149089

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