WALGREEN CO (NPI# 1043225170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043225170 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #6868 |
| Practice Address |
330 W State Blvd Fort Wayne IN 46808-3135 |
| Mailing Address |
1901 E Voorhees St Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 2604825428 |
| Practice Fax Number | 2604846355 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2015-12-15 |
| Authorized Official Name | MR. ALAN T NIELSEN (TREASURER) |
| Authorized Official Telephone | 8473153523 |
| Is Organization Subpart | Y |
| Parent Organization Name | WALGREENS BOOTS ALLIANCE INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | 60003683 | IN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100307730A | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1525356 | 01 |
| Other Name | Type Code |
|---|---|
| WALGREENS #6868 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306459615 | Walgreen Co | Pharmacy | 23335 Soboba Rd, San Jacinto, CA 92583 | 2020-08-26 |
| 1548873284 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 909 Veterans Blvd, Del Rio, TX 78840-4065 | 2020-08-24 |
| 1013527092 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 433 W Van Buren St Ste 150, Chicago, IL 60607-0433 | 2020-08-05 |
| 1801419650 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1301 N Main St Ste 100rx, Blacksburg, VA 24060-3129 | 2020-05-27 |
| 1699398602 | Walgreen Co | Pharmacy | 262 Danny Thomas Pl Ste 100rx, Memphis, TN 38105-3678 | 2020-05-26 |
| 1861021495 | Walgreen Co | Pharmacy | 1870 W Rio Salado Pkwy Ste 100rx, Tempe, AZ 85281-2695 | 2020-04-06 |
| 1154960722 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 41840 W Maricopa- Casa Grande Hwy, Maricopa, AZ 85138 | 2019-12-31 |
| 1932746047 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 300 W Broughton St, Savannah, GA 31401-3216 | 2019-12-09 |
| 1053955377 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1530 Celebration Blvd Ste 100rx, Kissimmee, FL 34747-5164 | 2019-10-30 |
| 1528600269 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 212a Moore Rd, King, NC 27021-8703 | 2019-10-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | WALGREEN CO. | 161 Washington Street, Suite 1400, Conshohocken, PA 19428 |
| Iowa Business Entities | WALGREEN CO. | 300 Wilmot Road, Deerfield, IL 60015 |
| Virginia Business Entities | WALGREEN CO. | 161 Washington St Ste 1400, Conshohocken, Pennsylvania 19428-2055 |
| Washington State Corporations | WALGREEN CO. | 300 Wilmot Rd, Deerfield, IL 60015-4614 |
| North Carolina Corporations | Walgreen Co. | 2626 Glenwood Avenue, Suite 550, Raleigh, NC 27608 |
| Oregon Corporations, Companies and Business Names | WALGREEN CO. | 300 Wilmot Road, Deerfield, IL 60015 |
| New York State Corporations | WALGREEN CO. | 80 State Street, Albany, New York 12207-2543 |
| Oklahoma Business Registrations | WALGREEN CO. | Attention Tax Department, 200 Wilmot Road, Deerfield, IL 60015 |
| Street Address |
330 W STATE BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46808-3135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437501921 | Jennifer Sposito | Pharmacist | 330 W State Blvd, Fort Wayne, IN 46808-3135 | 2016-07-07 |
| 1528440021 | Matthew Schafer | Pharmacist | 330 W State Blvd, Fort Wayne, IN 46808-3135 | 2015-06-22 |
| 1548543127 | James Victor Counterman | Pharmacist | 330 W State Blvd, Fort Wayne, IN 46808-3135 | 2011-09-21 |
| 1255614954 | Leslie Palmer | Pharmacist | 330 W State Blvd, Fort Wayne, IN 46808-3135 | 2011-09-20 |
| 1972886687 | Philippe Aa Pellerin Jr. | Pharmacist | 330 W State Blvd, Fort Wayne, IN 46808-3135 | 2011-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347102 | Austin Hartzog | Pharmacist | 5110 Value Drive, Fort Wayne, IN 46808 | 2020-08-21 |
| 1407358377 | Bryan Black | Specialist/Technologist | 3946 Ice Way Fort Wayne, Fort Wayne, IN 46808 | 2018-03-06 |
| 1326557877 | Kimberly K Kolb | Occupational Therapy Assistant | 1431 Runnion Ave, Fort Wayne, IN 46808 | 2017-09-28 |
| 1396142063 | Christina Ryder | Specialist/Technologist | 3946 Iceway, Fort Wayne, IN 46808 | 2014-11-25 |
| 1912090440 | Neighborcare of Indiana, LLC | Pharmacy | 3402 Congressional Pkwy, Ft. Wayne, IN 46808 | 2006-10-02 |
| 1619945888 | Beth Ann Herrell | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2006-03-14 |
| 1568458990 | Carolyn Warner Greer | Obstetrics & Gynecology | 1415 Directors Row, Fort Wayne, IN 46808 | 2005-09-21 |
| 1750851168 | Tyler Cheney | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-28 |
| 1487123550 | Michaela Mcguire | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-19 |
| 1861961088 | Olivia Marquardt | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-16 |
| Find all providers in zip 46808 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053951210 | Pharmacy Corporation of America | Pharmacy | 6032 Highview Dr Ste C, Fort Wayne, IN 46818-1390 | 2020-01-15 |
| 1124170014 | Creative Compounding Solutions LLC | Pharmacy | 2803 E State Blvd, Fort Wayne, IN 46805-4732 | 2007-01-18 |
| 1669545976 | Kroger Limited Partnership I | Pharmacy | 601 E Dupont Rd, Fort Wayne, IN 46825-2055 | 2006-11-16 |
| 1467525774 | Kroger Limited Partnership I | Pharmacy | 5725 Coventry Ln, Fort Wayne, IN 46804-7146 | 2006-11-16 |
| 1679646293 | Kroger Limited Partnership I | Pharmacy | 218 E Pettit Ave, Fort Wayne, IN 46806-3005 | 2006-11-15 |
| 1396818910 | Kroger Limited Partnership I | Pharmacy | 324 E State Blvd, Fort Wayne, IN 46805-3224 | 2006-11-15 |
| 1902979420 | Kroger Limited Partnership I | Pharmacy | 6002 Saint Joe Center Rd, Fort Wayne, IN 46835-2503 | 2006-11-15 |
| 1578594537 | K Mart Corp | Pharmacy | 7530 S Anthony Blvd, Fort Wayne, IN 46816 | 2006-07-06 |
| 1033607502 | Aaron Daseler | Pharmacy | 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2018-04-30 |
| 1811401052 | Rx Holdings, LLC | Pharmacy | 3537 N Anthony Blvd, Fort Wayne, IN 46805-1423 | 2017-11-27 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46808 |
Please comment or provide details below to improve the information on WALGREEN CO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.