WALGREEN CO (NPI# 1124033402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124033402 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #05348 |
| Practice Address |
34503 Yucaipa Blvd Yucaipa CA 92399-4129 |
| Mailing Address |
1901 E Voorhees St Ms790 Danville IL 61834-4509 |
| Practice Telephone | 9097907464 |
| Practice Fax Number | 9097978353 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2018-09-28 |
| 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 | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | PHY44760 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1124033402 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0548529 | 01 |
| Other Name | Type Code |
|---|---|
| WALGREENS #05348 | 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 |
34503 YUCAIPA BLVD |
| City | YUCAIPA |
| State | CA |
| Zip Code | 92399-4129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093257909 | Syeda A Gauhar | Pharmacist | 34503 Yucaipa Blvd, Yucaipa, CA 92399-4129 | 2016-11-08 |
| 1669896395 | Phoebe Mai | Pharmacist | 34503 Yucaipa Blvd, Yucaipa, CA 92399-4129 | 2014-02-18 |
| 1700127651 | Odette Matar | Pharmacist | 34503 Yucaipa Blvd, Yucaipa, CA 92399-4129 | 2013-03-01 |
| 1063785053 | Christina M Tudose | Pharmacist | 34503 Yucaipa Blvd, Yucaipa, CA 92399-4129 | 2012-02-21 |
| 1265709448 | Tiana Truong | Pharmacist | 34503 Yucaipa Blvd, Yucaipa, CA 92399-4129 | 2011-11-16 |
| 1275819062 | Tiana Phan | Pharmacist | 34503 Yucaipa Blvd, Yucaipa, CA 92399-4129 | 2011-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301941 | Emily Ambrosi | Occupational Therapist | 12257 Tulip Ln, Yucaipa, CA 92399 | 2020-09-23 |
| 1952943524 | Terrence Williams | Behavioral Analyst | 13768 Meadow View Lane, Yucaipa, CA 92399 | 2019-10-15 |
| 1235795097 | Han Acu&herbs, Inc | Acupuncturist | 32387 Yucaipa Blvd, Ste, F, Yucaipa, CA 92399 | 2019-05-16 |
| 1366926784 | David Gene Satre | Psychologist | 31752 Dove Ct, Yucaipa, CA 92399 | 2018-09-21 |
| 1336659861 | Titianna Little | Physical Therapist | 32819 Yucaipa Boulevard #3, Yucaipa, CA 92399 | 2017-10-11 |
| 1174043467 | Sharon Lee Pendola | Licensed Vocational Nurse | 11885 4th St, Yucaipa, CA 92399 | 2017-06-27 |
| 1073033072 | Juniper Manor, LLC | Skilled Nursing Facility | 35223 Juniper Avenue, Yucaipa, CA 92399 | 2017-06-21 |
| 1952858417 | Rafael Arias | Non-emergency Medical Transport (VAN) | 12386 17th St, Yucaipa, CA 92399 | 2016-09-01 |
| 1578906467 | Joyce I Bandele | Durable Medical Equipment & Medical Supplies | 34664 County Line Rd Suite 14, Yucaipa, CA 92399 | 2013-04-10 |
| 1033475108 | Loleta Michelle Gustafson | Marriage & Family Therapist | 34455 Yucaipa Blvd Ste 206, Yucaipa, CA 92399 | 2012-04-03 |
| Find all providers in zip 92399 | ||||
| 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 |
|---|---|---|---|---|
| 1689778631 | Domel Inc. | Pharmacy | 12350 California St, Yucaipa, CA 92399-4404 | 2006-09-12 |
| 1699122002 | Green Valley Pharmacy LLC | Pharmacy | 33733 Yucaipa Blvd Ste 1, Yucaipa, CA 92399-2256 | 2016-05-17 |
| 1326415985 | Nsn Family Inc | Pharmacy | 33490 Oak Glen Rd Ste E, Yucaipa, CA 92399-2095 | 2015-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528940 | Kaiser Foundation Health Plan Inc | Pharmacy | 4647 Zion Ave Fl4, Rm 4825, San Diego, CA 92120-2507 | 2020-11-06 |
| 1891394128 | Scriptdash Inc | Pharmacy | 4240 Kearny Mesa Rd Ste 107, San Diego, CA 92111-3769 | 2020-10-19 |
| 1235736737 | Scriptdash Inc | Pharmacy | 2360 Qume Dr, San Jose, CA 95131-1838 | 2020-10-07 |
| 1023615150 | Kaiser Foundation Health Plan Inc | Pharmacy | 9550 Escondido Ave Fl 1, Rm 1100, Hesperia, CA 92345-9120 | 2020-10-01 |
| 1033725478 | Happy Med Inc. | Pharmacy | 210 S Grand Ave Ste 116, Glendora, CA 91741-4262 | 2020-09-21 |
| 1366058794 | Joanna Jongae Kim | Pharmacy | 1020 S Anaheim Blvd Ste 101, Anaheim, CA 92805-5807 | 2020-09-21 |
| 1114532231 | Prime Rx San Gabriel, Inc. | Pharmacy | 533 W Las Tunas Dr # 102, San Gabriel, CA 91776-1133 | 2020-09-15 |
| 1164034260 | Tin Rx At The Tower Inc. | Pharmacy | 1801 Colorado Ave Ste 300, Turlock, CA 95382-2708 | 2020-08-19 |
| 1144831702 | Cameron Michael Rehmani Seraji | Pharmacy | 10542 Villa Del Cerro, Santa Ana, CA 92705-1486 | 2020-08-16 |
| 1881204907 | Kaiser Foundation Health Plan Inc | Pharmacy | 25821 S Vermont Ave Fl 4, Rm 4049, Harbor City, CA 90710-3518 | 2020-08-04 |
| 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.