WALGREEN CO (NPI# 1245245513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245245513 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #09593 |
| Practice Address |
3499 Bella Vista Way Bella Vista AR 72714-5740 |
| Mailing Address |
1901 E Voorhees St Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 4792739136 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2019-04-05 |
| 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 | AR20510 | AR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MEDICAID MO | 1245245513 | 01 |
| AR | 158294407 | 05 | |
| MO | 606375400 | 05 | |
| AR | 158111716 DME | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0422181 | 01 |
| Other Name | Type Code |
|---|---|
| WALGREENS #09593 | 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 |
3499 BELLA VISTA WAY |
| City | BELLA VISTA |
| State | AR |
| Zip Code | 72714-5740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861004988 | Vanessa Owl | Pharmacist | 3499 Bella Vista Way, Bella Vista, AR 72714-5740 | 2020-08-19 |
| 1346852860 | Kyle Conner | Pharmacist | 3499 Bella Vista Way, Bella Vista, AR 72714-5740 | 2020-08-17 |
| 1477961779 | Tabitha Layne Wortham | Pharmacist | 3499 Bella Vista Way, Bella Vista, AR 72714-5740 | 2014-07-30 |
| 1598032179 | Jeff Scott Norbeck | Pharmacist | 3499 Bella Vista Way, Bella Vista, AR 72714-5740 | 2011-11-26 |
| 1265719710 | Crayton Thomas Crisler | Pharmacist | 3499 Bella Vista Way, Bella Vista, AR 72714-5740 | 2011-11-11 |
| 1528345014 | Leigh Ann Brasel | Pharmacist | 3499 Bella Vista Way, Bella Vista, AR 72714-5740 | 2011-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710230701 | Maurice A Torres | Clinic/Center | 9 Cresswell Circle, Bella Vista, AR 72714 | 2012-10-16 |
| 1790801991 | Karra D Sparks | Nutritionist | #4 Hanover Drive, Bella Vista, AR 72714 | 2007-03-21 |
| 1659405132 | Bella Vista Hearing Center Pllc | Audiologist | 22 Sugar Creek Center, Bella Vista, AR 72714 | 2007-03-15 |
| 1144329798 | Albert Paul Price Jr. | Nurse Practitioner | 1 Mercy Way Ste 20, Bella Vista, AR 72714 | 2006-09-21 |
| 1679025324 | Marymargaret Portera | Case Manager/Care Coordinator | 2005 Se Walton Blvd, Bentonville, AR 72714 | 2016-10-28 |
| 1982979720 | Ashley L Goss | Nurse Practitioner | 1 Mercy Way Ste 20, Bella Vista, AR 72714 | 2012-03-13 |
| 1538459425 | Jennifer Jo Jennings | Nurse Practitioner | 1 Mercy Way Ste 20, Bella Vista, AR 72714 | 2011-04-12 |
| 1932313491 | Andrea Myane | Physical Therapist | 500 Tiger Blvd, Bentonville, AR 72714 | 2007-05-10 |
| 1427114644 | Robin Renee Ritter | Pharmacist | 408 Town Ctr Ne, Bella Vista, AR 72714-1817 | 2006-12-29 |
| 1841336765 | Bella Vista Pharmacy, Inc | Pharmacy | 408 Town Ctr Ne, Bella Vista, AR 72714-1817 | 2007-01-29 |
| Find all providers in zip 72714 | ||||
| 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 |
|---|---|---|---|---|
| 1831254259 | Faith Venture Pharmacy Inc | Pharmacy | 20 Sugar Creek Ctr, Bella Vista, AR 72714-3507 | 2006-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679198212 | Rachel Hardke | Pharmacy | 14984 Highway 86 W, Hazen, AR 72064-8348 | 2020-06-09 |
| 1821612326 | Sheridan Family Pharmacy LLC | Pharmacy | 677 Heritage Drive, Sheridan, AR 72150-5000 | 2020-06-01 |
| 1235614421 | Greenbrier Pharmacy Inc | Pharmacy | 61a South Broadview St, Greenbrier, AR 72058 | 2018-10-03 |
| 1376048124 | Bono Family Pharmacy, LLC | Pharmacy | 10040 Highway 63 S Ste 4, Bono, AR 72416-8669 | 2018-03-26 |
| 1073014866 | East End Express Pharmacy Inc | Pharmacy | 21019 Highway 167, Suite 100, Hensley, AR 72065 | 2018-02-27 |
| 1326546524 | White River Pharmacy, LLC | Pharmacy | 7321 W Sunset Ave Ste G, Springdale, AR 72762-0990 | 2018-01-23 |
| 1013422179 | Ppg Store 6 LLC | Pharmacy | 2235 Dave Ward Dr Ste 108, Conway, AR 72034-7040 | 2017-12-11 |
| 1952814857 | Health-wise Pharmacy Pllc | Pharmacy | 47 S Hwy 71 Bypass, Waldron, AR 72958 | 2017-11-14 |
| 1598278806 | Genoa Healthcare, LLC | Pharmacy | 21 Bridgeway Rd Ste P, North Little Rock, AR 72113-9514 | 2017-11-08 |
| 1811414972 | Genoa Healthcare, LLC | Pharmacy | 715 N College Ave Ste P1, El Dorado, AR 71730-4403 | 2017-08-29 |
| Find all providers with the same taxonomy | ||||
| City | BELLA VISTA |
| Zip Code | 72714 |
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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.