WALGREEN CO (NPI# 1538290135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538290135 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #07995 |
| Practice Address |
4765 Redan Rd Stone Mountain GA 30088-4550 |
| Mailing Address |
1901 E Voorhees St Ms #790 Danville IL 61834-4509 |
| Practice Telephone | 4042995322 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2015-12-29 |
| 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 | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | PHRE009133 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000942741Q | 05 | |
| NCPDP | 1155197 | 01 |
| Other Name | Type Code |
|---|---|
| WALGREENS #07995 | 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 |
4765 REDAN RD |
| City | STONE MOUNTAIN |
| State | GA |
| Zip Code | 30088-4550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235412321 | Fiseha Fettene | Pharmacist | 4765 Redan Rd, Stone Mountain, GA 30088-4550 | 2011-09-24 |
| 1225311558 | Shannon Brown | Pharmacist | 4765 Redan Rd, Stone Mountain, GA 30088-4550 | 2011-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565902 | Edward Edeh | Pharmacist | 1232 South Hairstoh Road, Stone Mountain, GA 30088 | 2020-10-16 |
| 1588124879 | Birds of Paradise Physical Therapy Services,llc | Physical Therapy Assistant | 754 Post Road Ln, Address Line 2, Stone Mountain, GA 30088 | 2019-03-22 |
| 1710467923 | Stephanie Patrice Mccray | In Home Supportive Care | 1058 Millard Road, Stone Mountain, GA 30088 | 2018-08-16 |
| 1912365321 | Audrey Perry | Respiratory Therapist, Certified | 1588 Linkview Close, Stone Mountain, GA 30088 | 2016-02-01 |
| 1689041428 | Reaching Above Poverty | Counselor | 5401 Megan Rd, Stone Mountain, GA 30088 | 2015-08-27 |
| 1043692254 | Bethany Johnson | Home Health Aide | 981 Deer Chase Court, Stone Mountain, GA 30088 | 2015-06-24 |
| 1073859666 | Whitney's Place Inc. | Custodial Care Facility | 5451 Rockbeidge Road, Stone Mountain, GA 30088 | 2012-12-31 |
| 1831468818 | The Art of Living Cla LLC. | Community/Behavioral Health | 1668 South Hairston Rd, Stone Mountain, GA 30088 | 2011-12-21 |
| 1659670792 | Atarah Ranit Kimmons | Occupational Therapist | 2045 County Down Lane, Stone Moutain, GA 30088 | 2011-03-15 |
| 1104060219 | William Tyrell Reid Jr. | Dentist | 1183 South Hairstron Rd., Suite D, Stone Mountain, GA 30088 | 2009-04-21 |
| Find all providers in zip 30088 | ||||
| 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 |
|---|---|---|---|---|
| 1922607662 | H & W Pharmacy | Pharmacy | 4091 Redan Rd Ste C, Stone Mountain, GA 30083-4767 | 2020-10-23 |
| 1780953737 | Discount Pharmacy | Pharmacy | 827 N Hairston Rd Ste D, Stone Mountain, GA 30083-3441 | 2011-12-20 |
| 1205129129 | Giovanni Nirmala | Pharmacy | 477 Tallwood Dr, Stone Mountain, GA 30083-4461 | 2011-05-25 |
| 1639358609 | Yasmin Discount Pharmacy LLC | Pharmacy | 5231 Memorial Dr # S-b1, Stone Mountain, GA 30083-3153 | 2007-10-26 |
| 1073660478 | Mckenzie Mansfield Pharmacy Services, LLC | Pharmacy | 4825 Rockbridge Rd, Suites 5 & 6, Stone Mountain, GA 30083-4297 | 2007-01-05 |
| 1356363907 | Target Corporation and Subsidiaries | Pharmacy | 2055 W Park Place Blvd, Stone Mountain, GA 30087-3531 | 2006-07-24 |
| 1942240379 | Publix Super Markets Inc | Pharmacy | 5158 Memorial Dr, Stone Mountain, GA 30083-3111 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720603756 | Medical-pharmacy Associates of Georgia, LLC | Pharmacy | 1425 Georgia Ave Ste 1, Macon, GA 31201-6546 | 2020-06-16 |
| 1700419454 | Janus Rx | Pharmacy | 836 E 65th St Ste 42, Savannah, GA 31405-4496 | 2020-02-20 |
| 1295373702 | Downtown Pharmacy LLC | Pharmacy | 236 Forsyth St Sw Ste 202b, Atlanta, GA 30303-3786 | 2019-12-16 |
| 1750928719 | Goodscript, Inc. | Pharmacy | 3115 Roswell Rd Ste 205, Marietta, GA 30062-7611 | 2019-12-09 |
| 1942844741 | Genoa Healthcare, LLC | Pharmacy | 400 Technology Ct Se Ste J, Room P, Smyrna, GA 30082-5237 | 2019-11-05 |
| 1225670995 | Allcare Pharmacy, LLC | Pharmacy | 1004 S Tennille Ave, Donalsonville, GA 39845 | 2019-10-14 |
| 1417598327 | Connect Care Pharmacy, LLC | Pharmacy | 2191 Hwy 247 Connector, Byron, GA 31008-5531 | 2019-10-02 |
| 1467003467 | Selamawit Dejene | Pharmacy | 464 Bishop St Nw Apt 336, Atlanta, GA 30318-5384 | 2019-09-23 |
| 1902454721 | Batts Drug Company Mansfield, LLC | Pharmacy | 4424 Highway 213, Mansfield, GA 30055-3211 | 2019-08-27 |
| 1619524865 | Clark Drug Company, LLC. | Pharmacy | 206 W 6th Street, Waynesboro, GA 30830 | 2019-08-22 |
| Find all providers with the same taxonomy | ||||
| City | STONE MOUNTAIN |
| Zip Code | 30088 |
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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.