Broadwater Drug #15669, Powered By Walgreens

LBN: Walgreen Co
Broadwater Drug #15669, Powered By Walgreens is an health care organization with primary practice located at 119 E Jackson St Ste 101, Gate City VA 24251-3418. 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 (276) 386-3821, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
119 E Jackson St Ste 101 Gate City VA 24251-3418
Phone: (276) 386-3821
Fax: (276) 386-7582
Website:
Map and Directions
Authorized official contact:
Name: Taylor, Kira
Phone: (217) 709-2351

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 020100069 Virginia
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1619214277
LBN Legal business name Walgreen Co
DBA Doing business as Broadwater Drug #15669, Powered By Walgreens
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 15th, 2013
Last updated May 2nd, 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 1619214277 NPPES
Virginia MEDICAID 1619214277
Virginia Other 4844470

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