WALGREEN CO (NPI# 1497760664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497760664 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #05992 |
| Practice Address |
3124 Line Ave Shreveport LA 71104-4240 |
| Mailing Address |
1901 E Voorhees St Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 3182224807 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2016-08-25 |
| Authorized Official Name | MR. ALAN T NIELSEN (TREASURER) |
| Authorized Official Telephone | 8473153523 |
| 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 | 4502RC | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1929667 | 01 | |
| LA | 1268143 | 05 |
| Other Name | Type Code |
|---|---|
| WALGREENS #05992 | 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 |
3124 LINE AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71104-4240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821348475 | Sharde Johnson | Pharmacist | 3124 Line Ave, Shreveport, LA 71104-4240 | 2012-09-11 |
| 1871875450 | Brenda Thomas Legaux | Pharmacist | 3124 Line Ave, Shreveport, LA 71104-4240 | 2011-09-09 |
| 1255611307 | Edmond Gabriel Ducote | Pharmacist | 3124 Line Ave, Shreveport, LA 71104-4240 | 2011-08-21 |
| 1013222801 | Christopher Lacour | Pharmacist | 3124 Line Ave, Shreveport, LA 71104-4240 | 2010-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326582263 | Dana Jackson | Counselor | 2425 Youree Drive, Shreveport, LA 71104 | 2016-12-12 |
| 1154772929 | Belena Cawthorne | Case Manager/Care Coordinator | 2040 Southern Ave, Shreveport, LA 71104 | 2016-06-23 |
| 1437505286 | Courtney Espenan | Counselor | 3825 Gilbert Dr Ste 124, Shreveport, LA 71104 | 2016-05-11 |
| 1215390497 | Joshua Mitchell | Counselor | 1106 Dalzell Street, Shreveport, LA 71104 | 2016-04-04 |
| 1699135426 | Amy Lutricia Krohn | Counselor | 1041 Dalzell St, Shreveport, LA 71104 | 2016-03-07 |
| 1225497779 | Annie Redding II | Counselor | 2525 Youree Dr Suite 110, Shreveport, LA 71104 | 2016-02-12 |
| 1891152328 | Council On Alcoholism and Drug Abuse of Northwest Louisiana | Community/Behavioral Health | 2000 Fairfield Ave, Shreveport, LA 71104 | 2016-01-28 |
| 1922465731 | Marteze Singleton | Case Manager/Care Coordinator | 2525 Youree Dr Ste 10, Shreveport, LA 71104 | 2016-01-25 |
| 1891160297 | Damara Mora | Counselor | 2620 Centenary Blvd Bldg3 Ste 312, Shreveport, LA 71104 | 2015-12-10 |
| 1962876250 | Chastity Shermaine Graham | Counselor | 2620 Centenary Blvd Ste 312, Shreveport, LA 71104 | 2015-11-24 |
| Find all providers in zip 71104 | ||||
| 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 |
|---|---|---|---|---|
| 1588036552 | Brfhh Shreveport LLC | Pharmacy | 1541 Kings Hwy Rm Eg-10, Shreveport, LA 71103-4228 | 2015-10-29 |
| 1982962890 | Jewella Avenue Pharmacy | Pharmacy | 3610 Jewella Ave, Suite B, Shreveport, LA 71109-4700 | 2012-04-27 |
| 1265675029 | Martin Luther King Health Center | Pharmacy | 1233 Sprague St., Shreveport, LA 71101 | 2009-04-09 |
| 1134272644 | Pill Box Pharmacy Incorporated | Pharmacy | 1849 Line Ave, Shreveport, LA 71101-4611 | 2007-01-19 |
| 1114090446 | Brookshire Grocery Company | Pharmacy | 388 Bert Kouns Loop, Attention Pharmacy Dept, Shreveport, LA 71106-8123 | 2006-11-16 |
| 1952474421 | Brookshire Grocery Company | Pharmacy | 3620 Pines Rd, Attention Pharmacy Dept, Shreveport, LA 71119-5206 | 2006-11-15 |
| 1861565335 | Brookshire Grocery Company | Pharmacy | 510 Kings Hwy, Attention Pharmacy Dept, Shreveport, LA 71104-4444 | 2006-11-15 |
| 1316010887 | Brookshire Grocery Company | Pharmacy | 5828 Line Ave, Attention Pharmacy Dept, Shreveport, LA 71106-1532 | 2006-11-15 |
| 1225101793 | Brookshire Grocery Company | Pharmacy | 3000 N Market St, Attention Pharmacy Dept, Shreveport, LA 71107-4062 | 2006-11-15 |
| 1780757252 | Brookshire Grocery Company | Pharmacy | 2640 Waggoner Ave, Attention Pharmacy Dept, Shreveport, LA 71108-3859 | 2006-11-15 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71104 |
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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.