WALGREEN CO. (NPI# 1912131095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912131095 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO. |
| Other Organization Name | WALGREENS #10918 |
| Practice Address |
4210 N Roan St Johnson City TN 37601-1130 |
| Mailing Address |
1901 E Voorhees St Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 4232620201 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2016-01-09 |
| 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 | 4645 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 4442315 | 05 | |
| NCPDP | 4442315 | 01 |
| Other Name | Type Code |
|---|---|
| Walgreens #10918 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457733222 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 418 Us Highway 22 W, Whitehouse Station, NJ 08889 | 2015-06-29 |
| 1215334651 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 1 Eddie Dowling Hwy, North Smithfield, RI 02896-7305 | 2014-12-01 |
| 1093112708 | Walgreen Co. | Pharmacy | 500 Route 530, Whiting, NJ 08759 | 2014-11-24 |
| 1164821070 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 339 Matawan Rd, Matawan, NJ 07747-3901 | 2014-08-15 |
| 1306198973 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 447 Belmont Ave, Haledon, NJ 07508-1368 | 2012-10-08 |
| 1437423670 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 901 S Rancho Dr Ste 20, Las Vegas, NV 89106 | 2012-03-06 |
| 1396018883 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 115 N Euclid Ave Ste A, Saint Louis, MO 63108-1503 | 2012-02-15 |
| 1013280403 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 2100 Lyndale Ave S Ste A, Minneapolis, MN 55405 | 2012-02-15 |
| 1588936850 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 4101 Greenbriar Dr Ste 235, Houston, TX 77098 | 2012-02-02 |
| 1467724716 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 8490 Santa Monica Blvd Ste 1, West Hollywood, CA 90069-4261 | 2012-02-02 |
| 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 |
4210 N ROAN ST |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37601-1130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255356366 | Brad Alan Phelps | Pharmacist | 4210 N Roan St, Johnson City, TN 37601-1130 | 2006-07-12 |
| 1942616123 | Alex Rhodes | Pharmacist | 4210 N Roan St, Johnson City, TN 37601-1130 | 2014-07-08 |
| 1831442599 | Joshua Ryne Blake | Pharmacist | 4210 N Roan St, Johnson City, TN 37601-1130 | 2012-10-18 |
| 1376825042 | Brittany May | Pharmacist | 4210 N Roan St, Johnson City, TN 37601-1130 | 2011-09-19 |
| 1083935290 | Christopher James Watts | Pharmacist | 4210 N Roan St, Johnson City, TN 37601-1130 | 2010-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396381992 | Juan Carlos Simon Villegas Gomez | Specialist/Technologist | 1081 John Robert Bell Dr, Johnson City, TN 37601 | 2019-11-19 |
| 1629537279 | Jaima Suzanne Price | Hearing Instrument Specialist | 106 E Watauga Avenue, Johnson City, TN 37601 | 2019-03-13 |
| 1275004467 | Brittany Howell | Speech-Language Pathologist | 2114 E. Fairview Ave, Johnson City, TN 37601 | 2018-12-16 |
| 1194229948 | Heather Chantel Lester | Physical Therapist | 2114 E. Fairview Avenue, Johnson City, TN 37601 | 2018-03-19 |
| 1477061869 | Patrick Conway Reynolds | Specialist/Technologist | 1081 John Robert Bell Drive, Johnson City, TN 37601 | 2018-01-19 |
| 1790201135 | Surgical Services of East Tennessee PC | Surgery | 300 East Main St., Suite 301, Johnson City, TN 37601 | 2017-08-17 |
| 1073065694 | Davina Leah Reppond | Home Health | 1204 E Myrtle Ave, Johnsoncity, TN 37601 | 2016-10-31 |
| 1003365503 | Wendi Y Minutolo | Behavioral Analyst | 403 Princeton Rd Ste 3, Johnson City, TN 37601 | 2016-09-25 |
| 1306208798 | Rachel Anne Anderson | Nurse Practitioner | 1118 East Holston Avenue, Johnson City, TN 37601 | 2016-03-24 |
| 1932560976 | Kaydee Louise Davidson | Occupational Therapist | 3209 Bristol Highway, Johnson City, TN 37601 | 2016-03-18 |
| Find all providers in zip 37601 | ||||
| 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 |
|---|---|---|---|---|
| 1396206140 | Tennessee Choice Pharmacy LLC | Pharmacy | 525 W Oakland Ave Ste 5, Johnson City, TN 37604-1673 | 2019-03-26 |
| 1801026638 | Txex Med LLC | Pharmacy | 405 Hwy 281 South, Johnson City, TX 78636 | 2009-07-14 |
| 1568599306 | Rowan Enterprises Inc | Pharmacy | 4729 N Roan St, Ste 2, Johnson City, TN 37615-3959 | 2007-02-28 |
| 1033280052 | Apothecary Inc | Pharmacy | 1301 N Roan St, Johnson City, TN 37601-3941 | 2006-11-13 |
| 1881628527 | Kroger Limited Partnership I | Pharmacy | 112 Sunset Dr, Johnson City, TN 37604-2503 | 2006-07-10 |
| 1639148687 | Wegmans Food Markets, Inc. | Pharmacy | 650 Harry L Dr, Attn: Pharmacy Manager, Johnson City, NY 13790-1146 | 2006-03-14 |
| 1053922195 | Nathaniel Wilson | Pharmacy | 429 N State of Franklin Rd, Johnson City, TN 37604-6034 | 2020-08-12 |
| 1821392663 | United Health Services Hospitals Inc | Pharmacy | 52 Harrison St, Johnson City, NY 13790-2120 | 2011-01-10 |
| 1972518520 | Lb Prescription Enterprises Inc | Pharmacy | 711 Main St, Johnson City, NY 13790-1743 | 2006-07-30 |
| 1033143789 | Kroger Limited Partnership I | Pharmacy | 1805 W State of Franklin Rd, Johnson City, TN 37604-8801 | 2006-07-10 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37601 |
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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.