Walgreens #11758

LBN: Walgreen Co
Walgreens #11758 is an health care organization with primary practice located at 6665 Highway 85 , Riverdale GA 30274-2346. 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 (770) 907-6934, or through Taylor, Kira L via phone (217) 709-2351.

Contact Information

Primary practice address
6665 Highway 85 Riverdale GA 30274-2346
Fax: (770) 907-6940
Website:
Authorized official contact:
Name: Taylor, Kira L

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PHRE009564 Georgia
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1649417171
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #11758
Authorized official Taylor, Kira L
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 21st, 2009
Last updated Nov 1st, 2023 - about last year

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 1649417171 NPPES
Other 1158345 NCPDP
Other 205408933B NCPDP
MEDICAID 205408933A NCPDP

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