Walgreens #12756
LBN: Walgreen Co
Walgreens #12756 is an health care organization with primary practice located at 2025 1St Ave Se , Moultrie GA 31788-5155. 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 (229) 890-2776, or through Taylor, Kira via phone (217) 709-2351.
Contact Information
Primary practice address
2025 1St Ave Se
Moultrie GA 31788-5155
Phone: (229) 890-2776
Fax: (229) 985-3025
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | PHRE009932 | Georgia |
| Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
| NPI number | 1457693004 |
|---|---|
| LBN Legal business name | Walgreen Co |
| DBA Doing business as | Walgreens #12756 |
| Authorized official | Taylor, Kira |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Mar 21st, 2013 |
| Last updated | Apr 6th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457693004 | NPPES |
| Georgia | Other | 1163308 | NCPDP |
| Georgia | MEDICAID | 003137212A | NCPDP |
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