WALGREEN CO. (NPI# 1205084266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205084266 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO. |
| Other Organization Name | WALGREENS #11165 |
| Practice Address |
5445 State Road 16 St Augustine FL 32092-0617 |
| Mailing Address |
1901 E Voorhees St Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 9049405556 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2008-09-03 |
| 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 | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 1037907 | 01 | |
| FL | 000487500 | 05 | |
| FL | FL MEDICAID DME | 000487501 | 01 |
| Other Name | Type Code |
|---|---|
| Walgreens #11165 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457733222 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 418 Us Highway 22 W, Whitehouse Station, NJ 08889 | 2015-06-29 |
| 1215334651 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 1 Eddie Dowling Hwy, North Smithfield, RI 02896-7305 | 2014-12-01 |
| 1093112708 | Walgreen Co. | Pharmacy | 500 Route 530, Whiting, NJ 08759 | 2014-11-24 |
| 1164821070 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 339 Matawan Rd, Matawan, NJ 07747-3901 | 2014-08-15 |
| 1306198973 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 447 Belmont Ave, Haledon, NJ 07508-1368 | 2012-10-08 |
| 1437423670 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 901 S Rancho Dr Ste 20, Las Vegas, NV 89106 | 2012-03-06 |
| 1396018883 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 115 N Euclid Ave Ste A, Saint Louis, MO 63108-1503 | 2012-02-15 |
| 1013280403 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 2100 Lyndale Ave S Ste A, Minneapolis, MN 55405 | 2012-02-15 |
| 1588936850 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 4101 Greenbriar Dr Ste 235, Houston, TX 77098 | 2012-02-02 |
| 1467724716 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 8490 Santa Monica Blvd Ste 1, West Hollywood, CA 90069-4261 | 2012-02-02 |
| 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 |
5445 STATE ROAD 16 |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32092-0617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255613139 | Mita P Patel | Pharmacist | 5445 State Road 16, St Augustine, FL 32092-0617 | 2011-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124670146 | Kaitlyn Thomas | Speech-Language Pathologist | 111 Nature Walk Pkwy # B101, Saint Augustine, FL 32092 | 2019-07-10 |
| 1386168359 | Westminster Pines, Inc. | Skilled Nursing Facility | 235 Towerview Drive, St. Augustine, FL 32092 | 2017-08-01 |
| 1255852471 | St Vincent's Urgent Care Inc | Clinic/Center | 2001 Country Road 210 West, St Augustine, FL 32092 | 2017-06-28 |
| 1649702291 | Leonard Volpe | Physician Assistant | 745 Porta Rosa Cir, St Augustine, FL 32092 | 2017-04-03 |
| 1740630425 | Sierra Danielle Shultz | Behavioral Analyst | 2590 C H Arnold Rd, Saint Augustine, FL 32092 | 2016-06-14 |
| 1023467347 | Marylin Palackel James | Family Medicine | 110 Hampton Point Dr, St Augustine, FL 32092 | 2016-06-07 |
| 1790146462 | Florida Autism Center | Community/Behavioral Health | 124 Capulet Drive, St Augustine, FL 32092 | 2016-03-09 |
| 1174901458 | Kaylan Brady | Pediatrics | 70 Turin Terrace, Suite 220, St Augustine, FL 32092 | 2015-05-07 |
| 1245620368 | Angela Sanchez | Physician Assistant | 229 Adelanto Ave, St Augustine, FL 32092 | 2015-01-27 |
| 1053723700 | David Hamilton | Dentist | 149 Tuscan Way, St. Augustine, FL 32092 | 2014-05-29 |
| Find all providers in zip 32092 | ||||
| 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 |
|---|---|---|---|---|
| 1548595416 | Publix Super Markets Inc | Pharmacy | 955 State Road 16, St Augustine, FL 32084-1857 | 2009-10-12 |
| 1063445229 | St Johns Pharmacy Incorporated | Pharmacy | 2720 Us 1 S, Suite A, St Augustine, FL 32086-6301 | 2006-07-09 |
| 1558392662 | K Mart Corp | Pharmacy | 1777 Us Highway 1 S, St Augustine, FL 32084-4238 | 2006-07-06 |
| 1740223023 | First Choice Phcy Svcs LLC | Pharmacy | 110 Cumberland Dr #305, St Augustine, FL 32095 | 2006-06-14 |
| 1245283423 | Seaside Family Pharmacy LLC | Pharmacy | 4075 A1a S, Ste 102, St Augustine, FL 32080-6773 | 2006-05-18 |
| 1740270099 | Moultrie Pharmacy Inc | Pharmacy | 3690 Us Highway 1 S, St Augustine, FL 32086-6498 | 2005-10-27 |
| 1710975982 | Flagler Community Pharmacy Inc | Pharmacy | 300 Health Park Blvd, Suite 1002, St Augustine, FL 32086-3707 | 2005-10-11 |
| 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 | ||||
| City | ST AUGUSTINE |
| Zip Code | 32092 |
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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.