WALGREEN CO (NPI# 1639471352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639471352 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #12706 |
| Practice Address |
900 E Main St Waterford WI 53185-4536 |
| Mailing Address |
1901 E Voorhees St Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 2625144290 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2016-01-13 |
| 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 | 9051-042 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1639471352 | 05 | |
| NCPDP | 5132458 | 01 |
| Other Name | Type Code |
|---|---|
| WALGREENS #12706 | 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 |
900 E MAIN ST |
| City | WATERFORD |
| State | WI |
| Zip Code | 53185-4536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164044491 | Pavneet Kaur Dhillon | Pharmacist | 900 E Main St, Waterford, WI 53185-4536 | 2020-05-08 |
| 1407480809 | Colleen Kom | Pharmacist | 900 E Main St, Waterford, WI 53185-4536 | 2020-02-25 |
| 1285267872 | Spencer Polacek | Pharmacist | 900 E Main St, Waterford, WI 53185-4536 | 2020-02-21 |
| 1962810259 | Jonathan Lancourt | Pharmacist | 900 E Main St, Waterford, WI 53185-4536 | 2014-07-30 |
| 1184908287 | Jennifer Lucas | Pharmacist | 900 E Main St, Waterford, WI 53185-4536 | 2011-10-06 |
| 1528342797 | Kimberly Ruona | Pharmacist | 900 E Main St, Waterford, WI 53185-4536 | 2011-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649755695 | Alyssa Jane Revolinski | Respite Care | 269435 S Elm Lane, Waterford, WI 53185 | 2018-09-26 |
| 1871973370 | Julie Minikowski | Community Health Worker | 207 Milwaukee Avenue, A, Waterford, WI 53185 | 2015-06-01 |
| 1629235031 | Fluegge Optical | Technician/Technologist | 920 E Main Street, Waterford, WI 53185 | 2008-05-22 |
| 1659598209 | Julie Michals | Occupational Therapist | 1701 Sharp Road, Waterford, WI 53185 | 2007-04-18 |
| 1518072768 | Jennifer Jayne Decker | Family Medicine | 818 Forrest Ln, Waterford, WI 53185 | 2006-08-20 |
| 1215966908 | Amy Beth Flock | Physical Therapy Assistant | 2319 Fox Knoll Dr, Waterford, WI 53185 | 2006-07-03 |
| 1750762472 | Tesalia R Renteria | Family Medicine | 818 Forest Ln, Waterford, WI 53185 | 2015-06-18 |
| 1649651092 | Kathryn C Halyko | Pediatrics | 818 Forest Ln, Waterford, WI 53185 | 2015-06-11 |
| 1518109735 | Daniel A Allison | Family Medicine | 818 Forest Ln, Waterford, WI 53185 | 2009-04-02 |
| 1811178478 | Daniel Mark Gifford | Speech-Language Pathologist | 1701 Sharp Rd, Lakeview Specialty Hospital, Waterford, WI 53185 | 2007-11-23 |
| Find all providers in zip 53185 | ||||
| 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 |
|---|---|---|---|---|
| 1649794231 | Script Shop Bloomfield LLC | Pharmacy | 1060 W Huron St, Waterford, MI 48328-3730 | 2017-07-26 |
| 1902051345 | Waterford Pharmacy | Pharmacy | 5812 Highland, Waterford, MI 48328 | 2008-11-26 |
| 1952490583 | Big Y Foods Inc | Pharmacy | 128 Boston Post Rd, Waterford, CT 06385-2817 | 2006-10-12 |
| 1134211204 | The Pharmacy Station Inc | Pharmacy | 601 N Milwaukee St, Waterford, WI 53185-4405 | 2006-09-28 |
| 1255356812 | Bormans Inc | Pharmacy | 4998 Dixie Hwy, Waterford, MI 48329-1710 | 2006-07-13 |
| 1003840851 | Kroger Co of Michigan | Pharmacy | 5111 Highland Rd, Waterford, MI 48327-1915 | 2006-07-10 |
| 1700818663 | Stop and Shop Supermarket Co LLC | Pharmacy | 117 Boston Post Rd, Waterford, CT 06385-2400 | 2006-07-07 |
| 1033689922 | Michigan Urgent Care | Pharmacy | 5800 Highland Rd, Waterford, MI 48327-1827 | 2018-12-04 |
| 1619465358 | Vc Pharmacy Pllc | Pharmacy | 7300 Highland Rd, Waterford, MI 48327-1508 | 2018-04-27 |
| 1699910398 | Family Fare, LLC | Pharmacy | 7300 Highland Rd, Waterford, MI 48327-1508 | 2008-12-09 |
| Find all providers in WATERFORD | ||||
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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.