Walgreens #11209
LBN: Walgreen Co
Walgreens #11209 is an health care organization with primary practice located at 2850 Route 112 , Medford NY 11763-1404. 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 (631) 696-4018, or through Taylor, Kira via phone (217) 709-2351.
Contact Information
Primary practice address
2850 Route 112
Medford NY 11763-1404
Phone: (631) 696-4018
Fax: (631) 696-4074
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | 030948 | New York |
| Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
| NPI number | 1790067106 |
|---|---|
| LBN Legal business name | Walgreen Co |
| DBA Doing business as | Walgreens #11209 |
| Authorized official | Taylor, Kira |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Sep 12th, 2011 |
| Last updated | Nov 7th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790067106 | NPPES |
| New York | Other | 5803336 | NCPDP |
| New York | MEDICAID | 03415703 | NCPDP |
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