Walgreens #11781

LBN: Walgreen Co
Walgreens #11781 is an health care organization with primary practice located at 2964 W Martin Luther King Blvd , Fayetteville AR 72704-7682. 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 (479) 521-5103, or through Taylor, Kira L via phone (217) 709-2351.

Contact Information

Primary practice address
2964 W Martin Luther King Blvd Fayetteville AR 72704-7682
Fax: (479) 521-5282
Website:
Authorized official contact:
Name: Taylor, Kira L

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X AR20857 Arkansas
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1952564205
LBN Legal business name Walgreen Co
DBA Doing business as Walgreens #11781
Authorized official Taylor, Kira L
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 8th, 2008
Last updated Oct 25th, 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 1952564205 NPPES
Arkansas Other 0422915 NCPDP
Arkansas MEDICAID 172955407 NCPDP
Arkansas MEDICAID 174726716 DME NCPDP

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