WALGREEN CO (NPI# 1063427292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063427292 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #11493 |
| Practice Address |
1400 Broadway St Pekin IL 61554-3879 |
| Mailing Address |
1901 E Voorhees St Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 3093467879 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092386 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2017-01-26 |
| Authorized Official Name | MR. ALAN T NIELSEN JR. (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 | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | 54009581 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1456777 | 01 | |
| IL | 362127039553 | 05 |
| Other Name | Type Code |
|---|---|
| WALGREENS #11493 | 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 |
1400 BROADWAY ST |
| City | PEKIN |
| State | IL |
| Zip Code | 61554-3879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669086906 | Hany Tekel | Pharmacist | 1400 Broadway St, Pekin, IL 61554-3800 | 2020-09-03 |
| 1841534039 | Nishath Farooqui | Pharmacist | 1400 Broadway St, Pekin, IL 61554-3879 | 2012-11-12 |
| 1053693036 | Saritha Chodavarapu | Pharmacist | 1400 Broadway St, Pekin, IL 61554-3879 | 2011-09-15 |
| 1790065381 | Jason Nash | Pharmacist | 1400 Broadway St, Pekin, IL 61554-3879 | 2011-08-26 |
| 1730469487 | Rhonda Diane Jockisch | Pharmacist | 1400 Broadway St, Pekin, IL 61554-3879 | 2011-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194279000 | Shauna L Bivens | Nurse Practitioner | 3400 Griffin Ave., Pekin, IL 61554 | 2016-08-09 |
| 1720349780 | Neal Family Chiropractic PC | Chiropractor | 2978 Court St., Pekin, IL 61554 | 2012-06-06 |
| 1366750671 | Dennis Kammerer Stoller | Dentist | 1608 Broadway, Pekin, IL 61554 | 2010-09-21 |
| 1013186683 | Tazwood Mental Health Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1421 Valle Vista Blvd, Pekin, IL 61554 | 2008-02-27 |
| 1568631133 | Tazwood Mental Health Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1425 Valle Vista Blvd, Pekin, IL 61554 | 2008-02-27 |
| 1689856312 | Pekin Supportive Living Limited Patnership | Assisted Living Facility | 1320 Executive Court, Pekin, IL 61554 | 2007-12-05 |
| 1205034824 | Winfield Curtis Morgan | Dentist | 1503 Valle Vista, Pekin, IL 61554 | 2007-07-05 |
| 1376769638 | Debra Mollie Davis | Registered Nurse | 2079 Edgewater Dr, Pekin, IL 61554 | 2007-04-17 |
| 1649308230 | Tazewell County Health Department -dental Health Center | Public Health or Welfare | 135 Radio City Drive, Suite A & B, North Pekin, IL 61554 | 2007-03-02 |
| 1528118239 | Jerry Lee Marshall | Dentist | 135a-b Radio City Drive, North Pekin, IL 61554 | 2007-01-12 |
| Find all providers in zip 61554 | ||||
| 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 |
|---|---|---|---|---|
| 1518436757 | Oncology Hematology Associates of Central Il, PC | Pharmacy | 1641 Broadway St, Pekin, IL 61554-3805 | 2018-11-16 |
| 1538186895 | Walmart Inc. | Pharmacy | 3320 Veterans Dr, Pekin, IL 61554-9317 | 2006-07-16 |
| 1588695639 | Kmart Stores of Illinois LLC | Pharmacy | 2909 Court St, Pekin, IL 61554-6203 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702549 | Aster Pharmacy LLC | Pharmacy | 9213 Waukegan Rd, Morton Grove, IL 60053-2102 | 2020-05-27 |
| 1568083301 | Pointcore, Inc. | Pharmacy | 1800 N Knoxville Ave Ste G, Peoria, IL 61603-3028 | 2020-05-04 |
| 1336768001 | Mhg Pharmacy Services, LLC | Pharmacy | 2923 N California Ave Ste 240, Chicago, IL 60618-7702 | 2020-04-13 |
| 1184258824 | Metropolitian Austin Outpatient Pharmacy LLC | Pharmacy | 645 S Central Ave Ste 1, Chicago, IL 60644-5059 | 2020-03-02 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1568093615 | Carefirst Pharmacy, Inc. | Pharmacy | 2253 N Cicero Ave, Chicago, IL 60639-3327 | 2020-01-28 |
| 1720624521 | Affinity Pharmacy Care LLC | Pharmacy | 285 W Loop Rd Ste 1, Wheaton, IL 60189-2036 | 2019-11-27 |
| 1104462126 | Loyola University Medical Center | Pharmacy | 2160 S 1st Ave Rm 150-1610, Maywood, IL 60153-3328 | 2019-11-25 |
| 1346886512 | Value Plus Pharmacy LLC | Pharmacy | 457 W Liberty St, Wauconda, IL 60084-2452 | 2019-11-22 |
| 1841833100 | April M Bailey | Pharmacy | 1019 Oakcrest Dr, Rantoul, IL 61866-1118 | 2019-10-18 |
| Find all providers with the same taxonomy | ||||
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| 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.