WALGREEN CO (NPI# 1861537748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861537748 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | FIELDALE FARMS FAMILY HEALTH CARE CENTER & PHARMACY |
| Practice Address |
184 Professional Dr Unit B Baldwin GA 30511-4012 |
| Mailing Address |
1901 E Voorhees St Ms #790 Danville IL 61834-4509 |
| Practice Telephone | 8668942283 |
| Practice Fax Number | 7068942717 |
| Mailing Telephone | 2175548786 |
| Mailing Fax Number | 2175548546 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2009-10-20 |
| Authorized Official Name | MR. KERMIT R CRAWFORD (SR VICE PRESIDENT) |
| Authorized Official Telephone | 8479143154 |
| Is Organization Subpart | Y |
| Parent Organization Name | WALGREEN CO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | PHRE008894 | GA | Suppliers |
| Y | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
PHRE008894 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| U.S. GOV. DEA NO. | BM9073646 | 01 | |
| GA | STATE LICENSE NO. | PHRE008894 | 01 |
| NCPDP NO. | 1152684 | 01 |
| Other Name | Type Code |
|---|---|
| Fieldale Farms Family Health Care Center & Pharmacy | 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 |
184 PROFESSIONAL DR UNIT B |
| City | BALDWIN |
| State | GA |
| Zip Code | 30511-4012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952465056 | Meridian Corporate Healthcare of Georgia PC | Family Medicine | 184 Professional Dr Unit B, Baldwin, GA 30511-4012 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154536613 | Patricia A Sullens | Nutritionist | 441 Professional Complex, Suite 479d, Baldwin, GA 30511 | 2007-05-10 |
| 1023142304 | Nomora Corp | Pharmacy | 1667 Willingham Avenue, Baldwin, GA 30511 | 2007-03-16 |
| 1134404072 | Christy A Floyd | Nurse Practitioner | 155 Professional Dr, Baldwin, GA 30511 | 2011-10-11 |
| 1194182709 | Baldwin Pharmacy LLC | Pharmacy | 1667 Willingham Avenue, Baldwin, GA 30511-0910 | 2016-01-27 |
| 1902853427 | The Oaks - Scenic View Skilled Nursing, LLC | Skilled Nursing Facility | 205 Peach Orchard Rd, Baldwin, GA 30511-1803 | 2006-05-29 |
| 1548577026 | United Rehab Inc | Clinic/Center | 205 Peach Orchard Rd, Baldwin, GA 30511-1803 | 2010-09-07 |
| 1891735387 | Oak Manor LLC | Custodial Care Facility | 205 Peach Orchard Rd, Baldwin, GA 30511-1803 | 2006-06-07 |
| 1548539133 | Carl Douglas Little Jr. | Chiropractor | 386 Highway 441 Byp, Baldwin, GA 30511-1807 | 2011-12-28 |
| 1396899720 | Kurt Daniel York | Chiropractor | 386 Hwy 441 By Pass, Baldwin, GA 30511-1807 | 2007-01-23 |
| 1912066622 | John Keith Kleinert | Optometrist | 366 Highway 441 Bypass, Baldwin, GA 30511-1807 | 2006-12-08 |
| Find all providers in zip 30511 | ||||
| Taxonomy Code | 3336M0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Managed Care Organization Pharmacy |
| A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO’s covered members only. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316465859 | Integrated Health Solutions LLC | Pharmacy | 1284 Glandor Ct Se, Mableton, GA 30126-2755 | 2017-09-05 |
| 1174826754 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1478 Dogwood Dr Se, Conyers, GA 30013-5088 | 2010-12-21 |
| 1053612119 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 205 Newnan Crossing Byp, Newnan, GA 30265-1063 | 2010-11-05 |
| 1881910552 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 684 Sixes Rd Ste 275, Holly Springs, GA 30115-8721 | 2010-04-20 |
| 1144546920 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 455 Philip Blvd Ste 130, Lawrenceville, GA 30046-8767 | 2010-04-19 |
| 1699003681 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 201 W Ponce De Leon Ave, Decatur, GA 30030-3217 | 2009-12-02 |
| 1366622912 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 8011 Mall Pkwy, Lithonia, GA 30038-2543 | 2007-11-13 |
| 1518090836 | Northeast Georgia Health Services | Pharmacy | 825 Jesse Jewell Parkway Suite D, Gainesville, GA 30501-3715 | 2007-03-14 |
| 1578606950 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 3640 Tramore Pointe Pkwy, Austell, GA 30106-6825 | 2007-02-15 |
| 1568577450 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1745 Peachtree Rd Ne, Atlanta, GA 30309-2410 | 2006-08-20 |
| 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.