WALGREEN CO (NPI# 1467637868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467637868 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS # 11666 |
| Practice Address |
1820 S Springfield Ave Bolivar MO 65613-2563 |
| Mailing Address |
1901 E Voorhees St M/s #790 Danville IL 61834-4509 |
| Practice Telephone | 4177773700 |
| Mailing Telephone | 2177092386 |
| Enumeration Date | 2008-01-03 |
| 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 | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | NCPDP | 2637772 | 01 |
| MO | 606370500 | 05 |
| Other Name | Type Code |
|---|---|
| Walgreens # 11666 | Other Name - Individual/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 |
1820 S SPRINGFIELD AVE |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613-2563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710591193 | John R Myers II | Pharmacist | 1820 S Springfield Ave, Bolivar, MO 65613-2563 | 2020-09-03 |
| 1912511296 | Robert Wilkins | Pharmacist | 1820 S Springfield Ave, Bolivar, MO 65613-2563 | 2020-09-03 |
| 1568989283 | Jacob Witt | Pharmacist | 1820 S Springfield Ave, Bolivar, MO 65613-2563 | 2017-08-23 |
| 1558795864 | Sandra K Tooley | Pharmacist | 1820 S Springfield Ave, Bolivar, MO 65613-2563 | 2013-08-23 |
| 1942550769 | Kamila Michelle Truitt | Pharmacist | 1820 S Springfield Ave, Bolivar, MO 65613-2563 | 2012-09-19 |
| 1720361561 | Jaime Marsolf | Pharmacist | 1820 S Springfield Ave, Bolivar, MO 65613-2563 | 2011-09-27 |
| 1811270853 | Michael Lewis Crafton | Pharmacist | 1820 S Springfield Ave, Bolivar, MO 65613-2563 | 2011-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301552 | Casablanca Care Center, LLC | Home Health | 524 S. Albany Avenue, Bolivar, MO 65613 | 2020-09-18 |
| 1669087045 | Revive Medical LLC | Durable Medical Equipment & Medical Supplies | 5000, S Scenic, Bolivar, MO 65613 | 2020-09-11 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1932754744 | Caitlin M Williams | Specialist/Technologist | 1260 S Pike Avenue, Bolivar, MO 65613 | 2019-08-08 |
| 1073022406 | Jacquelyn Rose Kemnic | Dietitian, Registered | Heart Center, 1500 N Oakland Ave, Willard, MO 65613 | 2017-09-28 |
| 1164897161 | Ozarks Resource Group | Clinic/Center | 203 E. Broadway St., Bolivar, MO 65613 | 2015-12-02 |
| 1962895292 | Professional Christian Counseling | Counselor | 4888 S 139th Road, Bolivar, MO 65613 | 2015-03-11 |
| 1073916573 | Scott Leslie Dennis | Physician Assistant | 1500 North Oakland Ave, Citizens Memorial Hospital, Bolivar, MO 65613 | 2014-09-29 |
| 1053712109 | Citizens Memorial Hospital District | Pharmacy | 1301-b North Oakland, Bolivar, MO 65613 | 2014-09-09 |
| 1740680453 | Jamee M Stimpson | Occupational Therapist | 454 S. Main Avenue, Bolivar, MO 65613 | 2014-08-29 |
| Find all providers in zip 65613 | ||||
| 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 |
|---|---|---|---|---|
| 1013021328 | Sparks Pharmacy Inc | Pharmacy | 2000 S Springfield Ave, Bolivar, MO 65613-9654 | 2006-08-17 |
| 1801809785 | Sparks Pharmacy Inc | Pharmacy | 1001 E Cambridge St, Bolivar, MO 65613-3502 | 2006-08-14 |
| 1093726630 | Stephens Pharmacy Inc | Pharmacy | 1100 S Springfield Ave, Bolivar, MO 65613-2512 | 2006-08-10 |
| 1902838840 | Freds Stores of Tennessee Inc | Pharmacy | 105 Tennessee St, Bolivar, TN 38008-1822 | 2006-07-07 |
| 1255302451 | Citizens Memorial Health Care Foundation | Pharmacy | 1301b N Oakland Ave, Bolivar, MO 65613-3019 | 2006-01-27 |
| 1073078481 | Southern Express Pharmacy | Pharmacy | 1355 W Market St, Bolivar, TN 38008-1715 | 2019-02-10 |
| 1801318472 | Citizens Memorial Health Care Foundation | Pharmacy | 1100 S Springfield Ave, Bolivar, MO 65613-2512 | 2017-07-14 |
| 1639691959 | Citizens Memorial Health Care Foundation | Pharmacy | 1100 S Springfield Ave Ste A, Bolivar, MO 65613 | 2017-07-07 |
| 1750326195 | Portville Pharmacy Inc | Pharmacy | 323 Main St, Bolivar, NY 14715-1108 | 2006-06-19 |
| 1598723447 | The Hatchie Pharmacy LLC | Pharmacy | 640 Nuckolls Rd, Bolivar, TN 38008-1532 | 2006-05-02 |
| Find all providers in BOLIVAR | ||||
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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.