Walgreens #09465

LBN: Walgreen Co
Walgreens #09465 is an health care organization with primary practice located at 2615 Lake Rd , Dyersburg TN 38024-1605. 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 (731) 288-5065, or through Taylor, Kira via phone (217) 709-2351.

Contact Information

Primary practice address
2615 Lake Rd Dyersburg TN 38024-1605
Fax: (731) 288-6136
Website:
Authorized official contact:
Name: Taylor, Kira

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 4202 Tennessee
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1871508812
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #09465
Authorized official Taylor, Kira
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 29th, 2006
Last updated Nov 2nd, 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 1871508812 NPPES
Tennessee MEDICAID 4438429
Tennessee Other 4438429

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