Walgreens #04804

LBN: Walgreen Co
Walgreens #04804 is an health care organization with primary practice located at 1661 Nw Saint Lucie West Blvd , Port St Lucie FL 34986-2106. 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 (772) 873-1892, or through Taylor, Kira L via phone (217) 709-2351.

Contact Information

Primary practice address
1661 Nw Saint Lucie West Blvd Port St Lucie FL 34986-2106
Phone: (772) 873-1892
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 PH0016869 Florida
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1639184880
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #04804
Authorized official Taylor, Kira L
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 29th, 2006
Last updated Apr 14th, 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 1639184880 NPPES
Florida MEDICAID 021684400
Florida MEDICAID 021684401 DME
Florida Other 1086811

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