WALGREEN CO (NPI# 1275548430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275548430 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREEN #09402 |
| Practice Address |
3341 Halls Ferry Rd Vicksburg MS 39180-5338 |
| Mailing Address |
1901 E Voorhees St Mail Stop 790 Danville IL 61834-4509 |
| Practice Telephone | 6016619340 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2019-02-12 |
| 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 | 06665012 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 01678557 | 05 | |
| LA | 1202916 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2586103 | 01 |
| Other Name | Type Code |
|---|---|
| WALGREEN #09402 | 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 |
3341 HALLS FERRY RD |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39180-5338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225346489 | Rebecca Mcdole Sloan | Pharmacist | 3341 Halls Ferry Rd, Vicksburg, MS 39180-5338 | 2010-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255877346 | Elite Performance and Rehab, LLC | Clinic/Center | 1901 A Mission 66, Vicksburg, MS 39180 | 2017-01-12 |
| 1679931083 | Heather M Anderson | Physician Assistant | 2080 S Frontage Rd Ste 100, Vicksburg, MS 39180 | 2016-02-01 |
| 1245604941 | Warren County Assn.for Retarded Citizens, Inc. | Day Training, Developmentally Disabled Services | 100 Smokey Lane, Vicksburg, MS 39180 | 2015-11-18 |
| 1386012904 | Brian Oliver Snowden | Counselor | 3530 Manor Dr Ste 5a, Vicksburg, MS 39180 | 2015-09-14 |
| 1962802710 | Jordan P. Crocker, D.m.d., Pllc | Clinic/Center | 109 Monument Place, Vicksburg, MS 39180 | 2014-08-29 |
| 1821434259 | Trisha Addison | Physical Therapist | 2222 South Frontage Road, Suite D, Vicksburg, MS 39180 | 2013-05-13 |
| 1073862157 | Laura Jeanne Briggs | Physical Therapist | 1901-a Mission 66, Vicksburg, MS 39180 | 2012-09-05 |
| 1912175258 | Andrea T. Harris | Counselor | Warren-yazoo Mental Health Service, 3444 Wisconsin Ave., Vicksburg, MS 39180 | 2008-02-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1063539138 | Ollie Hardaway Jr. | Dentist | 154 Cottonwood Street, Vicksburg, MS 39180 | 2007-03-23 |
| Find all providers in zip 39180 | ||||
| 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 |
|---|---|---|---|---|
| 1972925303 | Reliant Medical LLC | Pharmacy | 3532 Manor Dr Ste 4, Vicksburg, MS 39180-5629 | 2014-01-21 |
| 1659606663 | Vicksburg Special Care Pharmacy and Compounding LLC | Pharmacy | 4079 Pemberton Square Blvd, Vicksburg, MS 39180-5580 | 2009-10-08 |
| 1912048646 | Amt Group LLC | Pharmacy | 1670 Highway 61 N, Vicksburg, MS 39183-3411 | 2007-02-08 |
| 1376601492 | Superco Inc | Pharmacy | 3040a Indiana Ave, Vicksburg, MS 39180-4355 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457973067 | Thomas Street Compounding Pharmacy | Pharmacy | 115 N Thomas St Ste G, Tupelo, MS 38801-3082 | 2020-05-18 |
| 1013558824 | Downhome Pharmacy, Inc. | Pharmacy | 606 W. Broad St, Monticello, MS 39654 | 2019-10-02 |
| 1356997985 | Sonshine Pharmacy, LLC | Pharmacy | 2745 Highway 371 N, Mantachie, MS 38855 | 2019-08-09 |
| 1699331868 | Fulton Specialty Pharmacy, LLC | Pharmacy | 1509 S Adams St Ste D, Fulton, MS 38843-6621 | 2019-05-14 |
| 1063971539 | National Pharmacy of Mississippi, LLC | Pharmacy | 371b Highland Colony Pkwy, Ridgeland, MS 39157-6035 | 2019-03-14 |
| 1811468952 | Davidson Pharmacy, LLC | Pharmacy | 203a N 2nd St, Booneville, MS 38829-2701 | 2018-12-16 |
| 1346710720 | Tupelo Specialty Pharmacy, LLC | Pharmacy | 1056 Cliff Gookin Blvd Ste C, Tupelo, MS 38801-6458 | 2018-11-28 |
| 1205302254 | A & A Infusion & Specialty, LLC | Pharmacy | 423 Mcallister St, Greenville, MS 38701-4704 | 2018-10-17 |
| 1306325402 | Family Drug Mart of Poplarville,llc | Pharmacy | 100 Highway 11 N, Poplarville, MS 39470-2217 | 2018-08-09 |
| 1851883789 | Amory Discount Pharmacy, LLC | Pharmacy | 60379 Cotton Gin Port Rd Ste B, Amory, MS 38821-7204 | 2018-06-06 |
| Find all providers with the same taxonomy | ||||
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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.