WALGREEN CO (NPI# 1104127349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104127349 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS # 11104 |
| Practice Address |
40079 Highway 27 Davenport FL 33837-7800 |
| Mailing Address |
1901 E Voorhees St Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 8635473903 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2018-05-08 |
| Authorized Official Name | ALYSSA SWEETEN (MANAGER) |
| Authorized Official Telephone | 2177092386 |
| 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 | PH25215 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 5702421 | 01 | |
| FL | 003200700 | 05 | |
| FL | MEDICAID DME | 003200701 | 01 |
| Other Name | Type Code |
|---|---|
| Walgreens # 11104 | 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 |
40079 HIGHWAY 27 |
| City | DAVENPORT |
| State | FL |
| Zip Code | 33837-7800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275872319 | Amanda Marciano | Pharmacist | 40079 Highway 27, Davenport, FL 33837-7800 | 2013-02-09 |
| 1427332360 | Howard Lawrence Wray | Pharmacist | 40079 Highway 27, Davenport, FL 33837-7800 | 2011-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922612274 | Kimberly Zariya Honaker | Massage Therapist | 398 Madison Drive, Davenport, FL 33837 | 2020-09-03 |
| 1609480375 | Sun Health and Wellness, Inc | Pharmacy | 109 Park Place Blvd, Suite A, Davenport, FL 33837 | 2020-09-01 |
| 1093323156 | Tammey Davis Payne | Counselor | 1423 Merrimack Lane, Davenport, FL 33837 | 2020-07-15 |
| 1346872835 | Shelly Hanson | Dietitian, Registered | 40100 Us 27, Davenport, FL 33837 | 2020-02-12 |
| 1689221269 | Adventist Health System /sunbelt, Inc. | Clinic/Center | 40124 Us Hwy 27, Suite 205, Davenport, FL 33837 | 2019-08-20 |
| 1578029039 | Portia P White | In Home Supportive Care | 108 East James St, Davenport, FL 33837 | 2019-02-20 |
| 1366937146 | Sheetal Kirat Parikh | Dietitian, Registered | 40100 Us Highway 27, Davenport, FL 33837 | 2018-06-25 |
| 1063929883 | Marisa Christine Sweetser | Registered Nurse | 40100 Us-27, Davenport, FL 33837 | 2018-01-02 |
| 1104341460 | Haley Kampf | Behavioral Analyst | 4303 Cortland Dr, Davenport, FL 33837 | 2017-08-08 |
| 1013438373 | Tamara Michelle Ortiz | Speech-Language Pathologist | 206 Nova Drive, Davenport, FL 33837 | 2017-06-27 |
| Find all providers in zip 33837 | ||||
| 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 |
|---|---|---|---|---|
| 1962929505 | Genoa Healthcare, LLC | Pharmacy | 1441 W Central Park Ave Ste 53, Davenport, IA 52804-1707 | 2017-08-24 |
| 1144415753 | Publix Super Markets Inc | Pharmacy | 39883 Highway 27, Davenport, FL 33837-7802 | 2007-09-07 |
| 1538191382 | K Mart Corp | Pharmacy | 3808 N Brady St, Davenport, IA 52806-6008 | 2006-07-06 |
| 1407825136 | Trp Inc | Pharmacy | 3002 Brady St, Davenport, IA 52803-1213 | 2006-03-15 |
| 1578636288 | Tampa Rx | Pharmacy | 206 W Orange St, Davenport, FL 33837-3118 | 2006-11-17 |
| 1427089481 | K Mart Corp | Pharmacy | 3616 W Kimberly Rd, Davenport, IA 52806-3001 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306452974 | Curry Ford Pharmacy LLC | Pharmacy | 4538 Curry Ford Rd, Orlando, FL 32812-2711 | 2020-09-19 |
| 1225641525 | Englewood Pharmaceutical Services Inc | Pharmacy | 1720 S Mccall Rd Ste J, Englewood, FL 34223-4867 | 2020-08-26 |
| 1972115103 | Intellrx Consulting LLC | Pharmacy | 1257 The 12th Fairway, Wellington, FL 33414-5738 | 2020-08-19 |
| 1518577576 | Publix Super Markets, Inc | Pharmacy | 7340 Kathleen Rd, Lakeland, FL 33810-4495 | 2020-08-05 |
| 1962011890 | Green Star Pharmacy | Pharmacy | 2950 Winkler Ave Ste 701, Fort Myers, FL 33916-9322 | 2020-07-27 |
| 1356959134 | Cverx Pharmacy Corp | Pharmacy | 7360 Sw 24th St Ste 29, Miami, FL 33155-1462 | 2020-07-17 |
| 1447877287 | Jerry Voltaire | Pharmacy | 16470 Cedar Run Dr, Orlando, FL 32828-6970 | 2020-06-27 |
| 1598381980 | John Melvin Schemm IIi | Pharmacy | 7617 Bay Port Rd, Orlando, FL 32819-5504 | 2020-06-22 |
| 1891318267 | Empire Specialty Pharmacy LLC | Pharmacy | 749 S Apollo Blvd, Melbourne, FL 32901-1457 | 2020-05-20 |
| 1992334205 | Mypills Pharmacy LLC | Pharmacy | 303a E 1st St, Sanford, FL 32771-1377 | 2020-04-07 |
| 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.