WALGREEN CO (NPI# 1730673385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730673385 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #21162 |
| Practice Address |
1301 W Palm Ave Ste 210 Jacksonville FL 32254 |
| Mailing Address |
1901 E Voorhees St # Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 4078596197 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2019-04-25 |
| 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 | 333600000X | Pharmacy | PH31617 | FL | Suppliers |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 000774801 | 05 | |
| FL | 100964900 | 05 | |
| FL | 000774800 | 05 | |
| FL | NCPDP | 5738159 | 01 |
| FL | DEA | FW7848798 | 01 |
| Other Name | Type Code |
|---|---|
| Walgreens #21162 | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1301 Palm Ave, Ste 210, Jacksonville, FL 32207 | 9045593504 | 9045593506 |
| 1301 W Palm Ave Ste 210, Jacksonville, FL 32254 | 4078596197 |
| 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 |
1301 W PALM AVE STE 210 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578072112 | Jules M Jean-pierre | Counselor | 2392 North Edgewood Avenue, Jacksonville, FL 32254 | 2017-09-27 |
| 1356869051 | Volaura Shanae Anderson | Counselor | 590 Ellis Rd, Jacksonville, FL 32254 | 2017-09-01 |
| 1962928291 | Angel Spivie | Counselor | 590 Ellis Road South Building 4, Jacksonville, FL 32254 | 2017-08-18 |
| 1376072777 | Tarkeshia Shuman | Contractor | 3150 Broadway Ave, Jacksoville, FL 32254 | 2017-06-08 |
| 1770931636 | Mamie Faith Peterson-mclaurn | Home Health | 2747 Sophia St, Jax, FL 32254 | 2016-06-01 |
| 1760803373 | Marian Lavonne Jones | Custodial Care Facility | 3501 Centerhill Dr. North, Jacksonville, FL 32254 | 2013-12-27 |
| 1659543981 | Monique Bosque-perez | Family Medicine | 781 Edgewood Ave N, Ufjp Commonwealth Family Practice, Jacksonville, FL 32254 | 2008-03-26 |
| 1508906652 | James Keith Riesz | Physical Therapist | 800 Lomax Street, Suite 105, Jacksonville, FL 32254 | 2007-02-07 |
| 1003903865 | Sabrina F Sessions | Pharmacist | 5050 Edgewood Court, Jacksonville, FL 32254 | 2006-10-05 |
| 1316048143 | Ester S Macam | Psychiatry & Neurology | 3333 West 20th Street, Jacksonville, FL 32254 | 2006-09-26 |
| Find all providers in zip 32254 | ||||
| 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 |
|---|---|---|---|---|
| 1467954438 | De2 LLC | Pharmacy | 2624 Atlantic Blvd Ste 3, Jacksonville, FL 32207-3633 | 2018-03-06 |
| 1174037063 | Banyanites - 2 LLC | Pharmacy | 11048 Baymeadows Rd Unit 5, Jacksonville, FL 32256-9583 | 2017-11-30 |
| 1538600424 | Can Community Health Inc. | Pharmacy | 4615 Philips Hwy, Suite 3, Jacksonville, FL 32207-9506 | 2017-03-13 |
| 1871039701 | An&u Inc | Pharmacy | 1729 S Jackson St, Jacksonville, TX 75766-5832 | 2017-01-17 |
| 1114479821 | Trucare Ltc, LLC | Pharmacy | 2671 Huffman Blvd, Jacksonville, FL 32246-4056 | 2016-10-28 |
| 1083161038 | Cornerstone Pharmacy Jacksonville LLC | Pharmacy | 315 S James St, Jacksonville, AR 72076-4315 | 2016-09-07 |
| 1326591066 | Sprx2 Inc | Pharmacy | 1201 Monument Rd Ste 100, Jacksonville, FL 32225-6445 | 2016-07-29 |
| 1568822377 | Sprx Inc | Pharmacy | 3740 Saint Johns Bluff Rd S Ste 21, Jacksonville, FL 32224-2650 | 2016-03-07 |
| 1548648363 | Caremax Pharmacy 725 LLC | Pharmacy | 5547 Normandy Blvd, Jacksonville, FL 32205-6246 | 2015-05-13 |
| 1538563580 | Florida A and M University College of Pharmacy | Pharmacy | 2050 Art Museum Dr, Suite 200, Jacksonville, FL 32207-2595 | 2014-10-20 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32254 |
Please comment or provide details below to improve the information on WALGREEN CO.
| 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.