Walgreens #05444

LBN: Walgreen Co
Walgreens #05444 is an health care organization with primary practice located at 212 S Logan Ave , Mattoon IL 61938-4595. 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 (217) 235-3191, or through Taylor, Kira L via phone (217) 709-2351.

Contact Information

Primary practice address
212 S Logan Ave Mattoon IL 61938-4595
Phone: (217) 235-3191
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Taylor, Kira L
Phone: (217) 709-2351

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 54004542 Illinois
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1629083761
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #05444
Authorized official Taylor, Kira L
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 29th, 2006
Last updated Apr 27th, 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 1629083761 NPPES
Illinois MEDICAID 362127039444
Illinois Other 1406481

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