WALGREEN CO (NPI# 1154337624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154337624 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #05791 |
| Practice Address |
1497 Canton Mart Rd Jackson MS 39211-5435 |
| Mailing Address |
1901 E Voorhees St Mail Stop 790 Danville IL 61834-4509 |
| Practice Telephone | 6019562421 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2019-02-11 |
| 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 | 05092012 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00330626 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2520535 | 01 |
| Other Name | Type Code |
|---|---|
| WALGREENS #05791 | 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 |
1497 CANTON MART RD |
| City | JACKSON |
| State | MS |
| Zip Code | 39211-5435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487208823 | Regan Nicole Tyler | Pharmacist | 1497 Canton Mart Rd, Jackson, MS 39211-5435 | 2019-07-24 |
| 1508344219 | Natalie Kern | Pharmacist | 1497 Canton Mart Rd, Jackson, MS 39211-5435 | 2018-08-03 |
| 1710310396 | Kirby Nicole Chesney | Pharmacist | 1497 Canton Mart Rd, Jackson, MS 39211-5435 | 2013-08-19 |
| 1033542329 | Katherine Duggan | Pharmacist | 1497 Canton Mart Rd, Jackson, MS 39211-5435 | 2013-08-09 |
| 1669804670 | Lindsey Lee | Pharmacist | 1497 Canton Mart Rd, Jackson, MS 39211-5435 | 2013-07-31 |
| 1770925166 | Michael A Noggle | Pharmacist | 1497 Canton Mart Rd, Jackson, MS 39211-5435 | 2013-07-25 |
| 1174965180 | Elizabeth Charlotte Cannon | Pharmacist | 1497 Canton Mart Rd, Jackson, MS 39211-5435 | 2013-07-19 |
| 1861743940 | Benita Pringle Ervin | Pharmacist | 1497 Canton Mart Rd, Jackson, MS 39211 | 2012-09-28 |
| 1366791584 | Allison Gallagher | Pharmacist | 1497 Canton Mart Rd, Jackson, MS 39211-5435 | 2012-09-04 |
| 1194073320 | Carletta Robinson | Pharmacist | 1497 Canton Mart Rd, Jackson, MS 39211-5435 | 2012-08-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
| 1548881048 | Gloria Dansby-giles | Counselor | 4500 Interstate 55, North; Suite 220, Jackson, MS 39211 | 2020-05-06 |
| 1821628223 | Alice Powell Taylor | St. Dominic Weight Loss Solutions, 3800 Interstate 55 North Frontage Road Suite 102, Jackson, MS 39211 | 2020-01-24 | |
| 1356980643 | Bethany Powers | Pharmacist | 4910 Interstate 55 North Frontage Rd, Jackson, MS 39211 | 2020-01-03 |
| 1316585581 | Deborah Magoun Rosenbaum | Pharmacist | [email protected], 4910 I-55 North, Jackson, MS 39211 | 2019-12-18 |
| 1285108357 | Eric Wood | Counselor | 4623 Maurey Rd, Jackson, MS 39211 | 2019-01-11 |
| 1649758301 | Isluv Robertson | Registered Nurse | 1405 E Northside Dr, Jackson, MS 39211 | 2018-08-03 |
| 1659863066 | Jonbrighton Childs Russell | Student in an Organized Health Care Education/Training Program | 4343 Dalrymple Ct, Jackson, MS 39211 | 2018-05-31 |
| 1225557598 | Regina Ann Day | Dietitian, Registered | 3800 I 55 North Frontage Road, Jackson, MS 39211 | 2017-09-18 |
| 1023558525 | Agilitas Usa Inc | Clinic/Center | 120 District Blvd E, Suite D102, Jackson, MS 39211 | 2017-03-02 |
| Find all providers in zip 39211 | ||||
| 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 |
|---|---|---|---|---|
| 1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
| 1912409475 | Moyes Pharmacy Inc | Pharmacy | 227 S Mulberry St, Jackson, GA 30233-2058 | 2018-03-01 |
| 1619410321 | Red Cap Pharmacy 001 LLC | Pharmacy | 214 N West Ave Ste A, Jackson, MI 49201-1903 | 2016-11-29 |
| 1285050864 | Lewis Family Drug, LLC | Pharmacy | 825 3rd St, Jackson, MN 56143-1187 | 2014-03-06 |
| 1356664239 | Stone Drug | Pharmacy | 830 W Broadway, Jackson, WY 83002-9000 | 2010-03-08 |
| 1215053061 | Country Market Pharmacies, L.L.C. | Pharmacy | 1410 W Ganson St, Jackson, MI 49202-4063 | 2007-03-22 |
| 1851467823 | Costplus Pharmacy | Pharmacy | 104a W University Pkwy, Jackson, TN 38305-1635 | 2006-11-28 |
| 1205909777 | Brookshire Grocery Company | Pharmacy | 2861 Terry Rd, Attention Pharmacy Dept, Jackson, MS 39212-3051 | 2006-11-15 |
| 1396818860 | Brookshire Grocery Company | Pharmacy | 5841 Ridgewood Rd, Attention Pharmacy Dept, Jackson, MS 39211-2618 | 2006-11-15 |
| 1861564486 | Brents Drugs of Belhaven | Pharmacy | 902b E Fortification St, Jackson, MS 39202 | 2006-11-15 |
| Find all providers in JACKSON | ||||
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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.