WALGREEN CO./ILL. (NPI# 1194002774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194002774 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO./ILL. |
| Practice Address |
4040 W 5415 S Salt Lake City UT 84118-4308 |
| Mailing Address |
200 Wilmot Rd Deerfield IL 60015-4620 |
| Practice Telephone | 8019821912 |
| Mailing Telephone | 8019821912 |
| Mailing Fax Number | 8019821932 |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2011-11-09 |
| Authorized Official Name | DR. CHAD JOLLEY (PHARMACIST) |
| Authorized Official Telephone | 8019821912 |
| Authorized Official Credential | PHARM D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
9691412-1701 | UT | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518381763 | Walgreen Co./ill. | Pharmacy | 7165 Columbia Gateway Dr, Columbia, MD 21046-2539 | 2014-02-07 |
| 1184051138 | Walgreen Co./ill. | Clinic/Center | 230 W Chrysler Dr, Belvidere, IL 61008-6304 | 2013-10-07 |
| Street Address |
4040 W 5415 S |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84118-4308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578578514 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 4040 W 5415 S, Salt Lake City, UT 84118-4308 | 2006-07-29 |
| 1841576469 | Chad Jolley | Pharmacist | 4040 W 5415 S, Salt Lake City, UT 84118-4308 | 2011-10-27 |
| 1952687543 | Tara Carlson | Pharmacist | 4040 W 5415 S, Salt Lake City, UT 84118-4308 | 2011-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225527500 | Hoan K Doan | Case Manager/Care Coordinator | 3809 West 6200 South, Kearns, UT 84118 | 2018-05-02 |
| 1750664785 | Giao L Tran | Pharmacist | 5586 W 6200 S, Slc, UT 84118 | 2011-09-26 |
| 1982913406 | Brent James Seely | Counselor | 5934 S 8400 W, Kearns, UT 84118 | 2010-10-01 |
| 1558593830 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Early Intervention Provider Agency | 5242 South 4820 West, Att Janet Wade, Kearns, UT 84118 | 2009-08-20 |
| 1063643120 | Phung Matthews | Pharmacist | 1837 West 4700 South, Taylorsville, UT 84118 | 2009-08-06 |
| 1689824963 | Mary Candace Christensen | Social Worker | 3703 West 6200 South, Valley Mental Health Artec - Therapeutic Foster Care, Bennion, UT 84118 | 2008-09-24 |
| 1164695128 | Life's Endeavour | Chiropractor | 2494 West Sharron Drive, Taylorsville, UT 84118 | 2008-04-10 |
| 1750585485 | Wendy Kay Cotting | Pediatrics | Taylorsville Kidscare, 3845 W. 4700 S., Taylorsville, UT 84118 | 2007-06-14 |
| 1720102841 | Wendy Lee Bingham | Physical Therapist | 3845 W. 4700 S., Ihc Taylorsville Health Center, Taylorsville, UT 84118 | 2007-03-16 |
| 1417028952 | Terry Milo Hansen | Optometrist | 2828 West 4700 South, Suite D, West Valley City, UT 84118 | 2006-11-13 |
| Find all providers in zip 84118 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518577741 | Black Panda LLC | Pharmacy | 2507 S State St, Salt Lake City, UT 84115-3109 | 2020-08-03 |
| 1447760228 | Meds In Motion, LLC | Pharmacy | 1200 E 3900 S Ste 1h, Salt Lake City, UT 84124-1300 | 2017-10-05 |
| 1164945192 | Walgreen Co | Pharmacy | 220 S 7th E, Salt Lake City, UT 84102-2106 | 2017-07-21 |
| 1417400797 | Hrx Pharmacy LLC | Pharmacy | 4227 S Highland Dr, Suite 6, Salt Lake City, UT 84124-2645 | 2016-08-03 |
| 1790157261 | Global Medical Therapeutics Inc | Pharmacy | 1890 S 3850 W Ste 121-a, Salt Lake City, UT 84104 | 2015-10-23 |
| 1457783201 | Pharmacare, LLC | Pharmacy | 729 N Redwood Rd, Attn Super Value Pharmacy, Salt Lake City, UT 84116-1909 | 2013-08-04 |
| 1568703650 | Amphex Pharmacy, LLC | Pharmacy | 898 E 3300 S, Salt Lake City, UT 84106-1508 | 2013-03-14 |
| 1043543754 | Associated Fresh Markets Inc | Pharmacy | 1638 S 9th E, Salt Lake City, UT 84105-2366 | 2009-09-13 |
| 1326371584 | Maceys Inc | Pharmacy | 4530 S Highland Dr, Salt Lake City, UT 84117-4202 | 2009-09-04 |
| 1275705493 | Walgreen Co | Pharmacy | 4690 S Holladay Blvd, Salt Lake City, UT 84117-5243 | 2008-03-27 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84118 |
Please comment or provide details below to improve the information on WALGREEN CO./ILL..
| 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.