WALGREEN CO (NPI# 1609399419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609399419 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #17987 |
| Practice Address |
9100 Pocahontas Trail Providence Forge VA 23140 |
| Mailing Address |
1901 E Voorhees St # Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 8049662151 |
| Practice Fax Number | 8049665017 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2019-11-20 |
| 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 | 0201001172 | VA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | NCPDP | 4848315 | 01 |
| VA | 1609399419 | 05 |
| Other Name | Type Code |
|---|---|
| Walgreens #17987 | 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 |
9100 POCAHONTAS TRAIL |
| City | PROVIDENCE FORGE |
| State | VA |
| Zip Code | 23140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538329339 | Aravind Kumar Reddy Kasireddy | Pharmacist | 9100 Pocahontas Trail, Providence Forge, VA 23140 | 2008-06-15 |
| 1326330085 | Jennifer Munn | Pharmacist | 9100 Pocahontas Trail, Providence Forge, VA 23140 | 2011-05-12 |
| 1770683138 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 9100 Pocahontas Trail, Providence Forge, VA 23140 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740411925 | Srikanth Mahavadi | Podiatrist | 9050 Pocahontas Trail, Suite F, Providence Forge, VA 23140 | 2009-08-05 |
| 1538343207 | Wendy Dickerson | Social Worker | 9403 A Pocahantas Trail, Providence Forge, VA 23140 | 2007-12-18 |
| 1528287463 | Randall Stephen Rosemond | Dentist | 3521 N Courthouse Road, Providence Forge, VA 23140 | 2007-04-25 |
| 1295879963 | Kim R Mcfadden | Physician Assistant | 9010 Pocahontas Trail, Providence Forge, VA 23140 | 2007-02-16 |
| 1326189226 | Andrea Michelle Johnson | Social Worker | 9403 Pocohantas Trail, Providence Forge, VA 23140 | 2007-02-12 |
| 1104902477 | Kent Paul Radwani | Social Worker | 9403 Pocohontas Trail, Providence Forge, VA 23140 | 2006-10-30 |
| 1366587396 | Janice V. Atwell | Social Worker | 9403 Pocohantas Trail, Providence Forge, VA 23140 | 2007-02-20 |
| 1437292455 | Clarice U. Baugh | Registered Nurse | 9403 Pocohantas Trail, Providence Forge, VA 23140 | 2007-02-15 |
| 1750602389 | Srikanth Mahavadi, Dpm PC | Clinic/Center | 9050 Pocahontas Trail, Suite #f, Providence Forge, VA 23140-0357 | 2010-06-17 |
| 1467697367 | Crossgap Ministries Inc. | Voluntary or Charitable | 5326 Adkins Rd, Providence Forge, VA 23140-2425 | 2008-12-05 |
| Find all providers in zip 23140 | ||||
| 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 |
|---|---|---|---|---|
| 1659998920 | Schiffert Health Center | Pharmacy | 895 Washington Street Sw Virginia Tech Mccomas Hall, Blacksburg, VA 24061-0140 | 2020-07-02 |
| 1912521675 | Duke Pharmacy LLC | Pharmacy | 5130 Duke St Ste 7b, Alexandria, VA 22304-2955 | 2020-05-28 |
| 1942847900 | Medspack Ltc Inc | Pharmacy | 14121 Parke Long Ct Ste 112, Chantilly, VA 20151-1647 | 2019-12-09 |
| 1275175804 | Duyen K Nguyen | Pharmacy | 4497 Morning Wind Ct, Annandale, VA 22003-5902 | 2019-10-15 |
| 1447892450 | Seaside Pharmacy LLC | Pharmacy | 1630 Donna Dr Ste 103, Virginia Beach, VA 23451-6188 | 2019-10-10 |
| 1083255426 | E's-y Rider Cab & Transport Co LLC | Pharmacy | 562 W 29th St, Buena Vista, VA 24416-1506 | 2019-10-07 |
| 1346891918 | Martin's Pharmacy of Rural Retreat Inc | Pharmacy | 100 W Buck Ave, Rural Retreat, VA 24368-2515 | 2019-09-25 |
| 1417418005 | Village Economy Drug Inc | Pharmacy | 443 Duff Patt Hwy Ste 104, Duffield, VA 24244-5191 | 2019-03-27 |
| 1538642434 | Avs Pharmacy LLC | Pharmacy | 161 Fort Evans Rd Ne Ste 115, Leesburg, VA 20176-3370 | 2018-09-07 |
| 1316427347 | Plaza Economy Drug Inc | Pharmacy | 1123 Plaza Dr, Grundy, VA 24614-6780 | 2018-08-20 |
| Find all providers with the same taxonomy | ||||
| City | PROVIDENCE FORGE |
| Zip Code | 23140 |
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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.