WALGREEN CO (NPI# 1417131160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417131160 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #10907 |
| Practice Address |
1410 N Bluff St Fulton MO 65251-2350 |
| Mailing Address |
1901 E Voorhees St M/s 790 Danville IL 61834-4509 |
| Practice Telephone | 5735927030 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2007-12-18 |
| 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 | 208019420 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 606381408 | 05 | |
| MO | NCPDP | 2637758 | 01 |
| Other Name | Type Code |
|---|---|
| Walgreens #10907 | 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 |
1410 N BLUFF ST |
| City | FULTON |
| State | MO |
| Zip Code | 65251-2350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629468756 | Ashley Miller | Pharmacist | 1410 N Bluff St, Fulton, MO 65251-2350 | 2015-01-27 |
| 1821375205 | Luanne Wooten Mcclure | Pharmacist | 1410 N Bluff St, Fulton, MO 65251-2350 | 2011-11-13 |
| 1689951048 | Barbara Jean Hauck | Pharmacist | 1410 N Bluff St, Fulton, MO 65251-2350 | 2011-11-12 |
| 1043595622 | Cheryl Ann Jackson | Pharmacist | 1410 N Bluff St, Fulton, MO 65251-2350 | 2011-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174008023 | East Central Missouri Behavioral Health Services, Inc. | Psychiatry & Neurology | 581 Commons Drive, Fulton, MO 65251 | 2018-09-26 |
| 1659888428 | Annette Marie Holt | Nurse Practitioner | 350 Country Meadows Lane, Fulton, MO 65251 | 2018-01-03 |
| 1922458454 | Benjamin Newell Crary | Family Medicine | 110 N Hosital Dr, Fulton, MO 65251 | 2016-06-15 |
| 1750763348 | Ssm Audrain Health Care, Inc | Clinic/Center | 350 Country Meadow Ln, Fulton, MO 65251 | 2015-06-19 |
| 1366829426 | Bigeye Emergency Physicians LLC | Emergency Medicine | 10 South Hospital Deive, Fulton, MO 65251 | 2015-04-28 |
| 1881019750 | Mid-missouri Hearing and Balance, Inc. | Audiologist-Hearing Aid Fitter | 850 W. Hospital Drive, Ste. G, Fulton, MO 65251 | 2014-02-28 |
| 1861828105 | Justin Ryan Campbell | Occupational Therapist | 508 Saint Eunice Road, Fulton, MO 65251 | 2013-09-18 |
| 1417257536 | June A Dillon | Counselor | 2625 Fairway Dr., Suite E, Fulton, MO 65251 | 2010-10-22 |
| 1033354196 | Michael K Mcelhinney | Specialist/Technologist | One University Avenue, William Woods University - Athletics, Fulton, MO 65251 | 2008-12-03 |
| 1326299967 | Karanbir Sandhu | Dentist | 1393 Highway O, Fulton, MO 65251 | 2008-10-01 |
| Find all providers in zip 65251 | ||||
| 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 |
|---|---|---|---|---|
| 1699331868 | Fulton Specialty Pharmacy, LLC | Pharmacy | 1509 S Adams St Ste D, Fulton, MS 38843-6621 | 2019-05-14 |
| 1750431334 | S & W Pharmacy Inc | Pharmacy | 116 S Cummings St, Fulton, MS 38843-1802 | 2007-01-12 |
| 1497849806 | Frank & Fran Drugs Inc | Pharmacy | 360 W 1st St S, Fulton, NY 13069-2441 | 2006-10-03 |
| 1558475848 | Golub Corporation | Pharmacy | 12 W 1st St S, Fulton, NY 13069-1635 | 2006-08-17 |
| 1790706026 | Penn Traffic Company The | Pharmacy | 2078 State Route 481, Fulton, NY 13069 | 2006-07-21 |
| 1205868148 | Freds Stores of Tennessee Inc | Pharmacy | 1409 S Adams St Ste 1a, Fulton, MS 38843-7629 | 2006-07-07 |
| 1902841265 | Dutch Pharmacies Inc | Pharmacy | 1313 S Adams St, Fulton, MS 38843-8862 | 2006-06-19 |
| 1326187212 | St of Mo Fulton St Hosp | Pharmacy | 600 E 5th St, Fulton, MO 65251-1753 | 2007-02-06 |
| 1821029976 | K Mart Corp | Pharmacy | 2078 State Rte 481 State 57, Fulton, NY 13069 | 2006-07-06 |
| 1477583326 | Evans Total Care, LLC | Pharmacy | 208 Lake St, Fulton, KY 42041-1544 | 2006-07-04 |
| Find all providers in FULTON | ||||
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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.