Walgreens # 12367

LBN: Walgreen Co
Walgreens # 12367 is an health care organization with primary practice located at 10613 N Knoxville Ave , Peoria IL 61615-1110. 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 (309) 243-1176, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
10613 N Knoxville Ave Peoria IL 61615-1110
Phone: (309) 243-1176
Fax: (309) 243-1187
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 054.019050 Illinois
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1770844623
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens # 12367
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 6th, 2012
Last updated Apr 1st, 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 1770844623 NPPES
Other 1486908 NCPDP

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