Walgreens #15805

LBN: Walgreen Co
Walgreens #15805 is an health care organization with primary practice located at 738 S Gloster St , Tupelo MS 38801-4932. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Walgreen Co can be contacted via phone (662) 844-0432, or through Nielsen, Alan T via phone (847) 315-3523.

Contact Information

Primary practice address
738 S Gloster St Tupelo MS 38801-4932
Fax: (662) 844-9853
Website:
Authorized official contact:
Name: Nielsen, Alan T

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 01443012 Mississippi
Suppliers / Pharmacy 333600000X 01443/01.2 Mississippi
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1497838015
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #15805
Authorized official Nielsen, Alan T
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 24th, 2006
Last updated Mar 16th, 2017 - about 7 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 1497838015 NPPES
Mississippi MEDICAID 00330366
Mississippi Other 870001323
Mississippi Other 01443012
Mississippi MEDICAID 330366
Mississippi Other 2511714

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