WALGREEN CO (NPI# 1790925691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790925691 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #10602 |
| Practice Address |
4310 Washington Rd Evans GA 30809-3957 |
| Mailing Address |
1901 E Voorhees St Ms #790 Danville IL 61834-4509 |
| Practice Telephone | 7068604179 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2016-08-30 |
| 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 | PHRE009567 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 1158460 | 01 | |
| GA | 133826348A | 05 | |
| GA | MEDICAID DME | 133826348B | 01 |
| Other Name | Type Code |
|---|---|
| WALGREENS #10602 | 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 |
4310 WASHINGTON RD |
| City | EVANS |
| State | GA |
| Zip Code | 30809-3957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407337306 | Jackleen Fan | Pharmacist | 4310 Washington Rd, Evans, GA 30809-3957 | 2018-08-28 |
| 1326558099 | Toan Hoang | Pharmacist | 4310 Washington Rd, Evans, GA 30809 | 2017-10-06 |
| 1336690312 | Mohamed Adan | Pharmacist | 4310 Washington Rd, Evans, GA 30809-3957 | 2016-10-14 |
| 1376090001 | Yiwen Zou | Pharmacist | 4310 Washington Rd, Evans, GA 30809-3957 | 2016-09-11 |
| 1891177234 | Josef Michael C Knecht | Pharmacist | 4310 Washington Rd, Evans, GA 30809-3957 | 2015-06-22 |
| 1174803811 | Randall Timothy Plant | Pharmacist | 4310 Washington Rd, Evans, GA 30809-3957 | 2011-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326674060 | Dominion Behavioral Health Services LLC | Psychiatric Unit | 817 Prairie Lane, Evans, GEORGIA 30809 | 2020-03-13 |
| 1710478102 | Georgia Dental Professionals, PC | Dentist | 5131 Washington Rd, Evans, GA 30809 | 2018-05-22 |
| 1649770678 | Angel Legare | Physician Assistant | 404 Town Park Blvd Ste 101, Evans, GA 30809 | 2018-02-16 |
| 1952829541 | Felicia Evette Rhodes | Home Health Aide | 715 Jones Creek, Evans, GA 30809 | 2017-09-02 |
| 1659733582 | Patricia J. Stewart Lpc, LLC | Counselor | 465 N. Belair Rd. Ste 2d, Evans, GA 30809 | 2016-03-21 |
| 1114306727 | John Mccaskey | Family Medicine | 465 N Belair Rd Ste 1b, Evans, GA 30809 | 2015-05-28 |
| 1053702878 | Jennifer Wahl | Assistant Behavior Analyst | 1135 Waltons Pass, Evans, GA 30809 | 2015-02-16 |
| 1609298777 | Custom Pharmacy, Inc | Pharmacy | 1202 Town Park Lane, Suite 200, Evans, GA 30809 | 2014-01-09 |
| 1457797938 | Perfect Health Always On Call, LLC | Non-Pharmacy Dispensing Site | 4244 Washington Rd, Evans, GA 30809 | 2013-05-11 |
| 1417207119 | Tommy Battle | Respiratory Therapist, Registered | 101 Pond View, Evans, GA 30809 | 2012-09-11 |
| Find all providers in zip 30809 | ||||
| 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 |
|---|---|---|---|---|
| 1376560615 | Wal-mart Stores East Lp | Pharmacy | 4469 Washington Rd, Evans, GA 30809-3807 | 2006-07-16 |
| 1245299973 | Medctr Inc | Pharmacy | 465 N Belair Rd, Suite 1a, Evans, GA 30809-3188 | 2006-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607662 | H & W Pharmacy | Pharmacy | 4091 Redan Rd Ste C, Stone Mountain, GA 30083-4767 | 2020-10-23 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.