WALGREEN CO (NPI# 1124198221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124198221 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #10365 |
| Practice Address |
308 S Main St Malvern AR 72104-3737 |
| Mailing Address |
1901 E Voorhees St Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 5014678197 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2019-03-21 |
| 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 | AR20551 | AR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 162515716 DME | 05 | |
| NCPDP | 0422561 | 01 | |
| AR | 162153407 | 05 |
| Other Name | Type Code |
|---|---|
| WALGREENS #10365 | 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 |
308 S MAIN ST |
| City | MALVERN |
| State | AR |
| Zip Code | 72104-3737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528670361 | William Lee Wallace | Pharmacist | 308 S Main St, Malvern, AR 72104-3737 | 2020-08-22 |
| 1255943619 | Jamelyn Landes | Pharmacist | 308 S Main St, Malvern, AR 72104-3737 | 2020-08-18 |
| 1043650005 | Amber Elizabeth Prescott | Pharmacist | 308 S Main St, Malvern, AR 72104-3737 | 2013-07-04 |
| 1871847095 | Ray B Harrison | Pharmacist | 308 S Main St, Malvern, AR 72104-3737 | 2012-11-09 |
| 1386913010 | John R Tipton IIi | Pharmacist | 308 S Main St, Malvern, AR 72104-3737 | 2011-12-27 |
| 1376820126 | Holly Hibbs | Pharmacist | 308 S Main St, Malvern, AR 72104-3737 | 2011-11-08 |
| 1154607224 | Walgreens | Pharmacy | 308 S Main St, Malvern, AR 72104-3737 | 2011-11-02 |
| 1679859375 | Ronald Lynn Headley | Pharmacist | 308 S Main St, Malvern, AR 72104-3737 | 2011-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659907707 | Terrence Randell Mitchell | Prosthetist | 991 Mount Willow Rd., Malvern, AR 72104 | 2020-03-20 |
| 1356837959 | American Oncology Partners, P.a. | Internal Medicine | 1001 Schneider Dr Ste 105, Malvern, AR 72104 | 2018-07-06 |
| 1114262839 | Charloda Nolen | Case Manager/Care Coordinator | 1710 E Page, Malvern, AR 72104 | 2012-12-06 |
| 1427349257 | Malvern Physical Therapy and Wellness | Physical Therapist | 1601 Hwy 270 W, Suite 104, Malvern, AR 72104 | 2011-04-27 |
| 1194037069 | Alternative Opportunities | Community/Behavioral Health | 1519 East Page Avenue, Malvern, AR 72104 | 2010-07-08 |
| 1285878991 | Pro-active Rehab Inc. | Physical Therapist | 720 Walco Rd, Suite 240, Malvern, AR 72104 | 2009-04-24 |
| 1932380599 | Vallerie Ahart | Licensed Practical Nurse | 1022 East Page, Malvern, AR 72104 | 2007-11-23 |
| 1104013598 | Vivian Brown | Home Health Aide | 913 Magnolia, Malvern, AR 72104 | 2007-09-28 |
| 1467665919 | Annette Jean Bowersox | Registered Nurse | 1399 Jenny Road, Malvern, AK 72104 | 2007-05-08 |
| 1730305798 | Jacqueline Kilgore LLC | Skilled Nursing Facility | 912 Section Line St, Malvern, AR 72104 | 2007-04-18 |
| Find all providers in zip 72104 | ||||
| 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 |
|---|---|---|---|---|
| 1205394749 | Cerner Health Connections, Inc | Pharmacy | 51 Valley Stream Pkwy, Malvern, PA 19355-1406 | 2019-03-04 |
| 1558689380 | Wegmans Food Markets, Inc. | Pharmacy | 50 Foundry Way, Att: Pharmacy Manager, Malvern, PA 19355 | 2010-05-04 |
| 1942384086 | S&w Pharmacy, Inc. | Pharmacy | 437 E Page Ave, Malvern, AR 72104-4249 | 2006-10-25 |
| 1396715777 | Deep South Home Medical Equipment, Inc | Pharmacy | 229 Sunrise Lane, Malvern, AL 36349 | 2006-01-26 |
| 1073088019 | Sakrx, LLC | Pharmacy | 403 Main St, Malvern, IA 51551-8137 | 2018-10-05 |
| 1225520653 | Jlgrx LLC | Pharmacy | 50 Three Tun Rd Ste 2, Malvern, PA 19355-3988 | 2018-06-01 |
| 1285921494 | Kohll's Pharmacy & Homecare | Pharmacy | 410 Main St, Malvern, IA 51551-8033 | 2011-07-08 |
| 1194941948 | Youngs Medicare Pharmacy | Pharmacy | 1304 S Main St, Malvern, AR 72104-5228 | 2007-04-18 |
| 1104989714 | Collins Drug | Pharmacy | 407 Main St, Malvern, IA 51551 | 2006-12-18 |
| 1801985452 | Millers Drug Store Inc | Pharmacy | 231 S Main St, Malvern, AR 72104-3736 | 2006-10-12 |
| Find all providers in MALVERN | ||||
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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.