WALGREEN CO. (NPI# 1003002254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003002254 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO. |
| Other Organization Name | WALGREENS #11113 |
| Practice Address |
5104 Bobby Hicks Hwy Gray TN 37615-6217 |
| Mailing Address |
1901 E Voorhees St Mailstop #790 Danville IL 61834-4509 |
| Practice Telephone | 4234773372 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2016-07-25 |
| 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 | 4444 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 4440664 | 01 | |
| TN | 4440664 | 05 |
| Other Name | Type Code |
|---|---|
| Walgreens #11113 | 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 |
5104 BOBBY HICKS HWY |
| City | GRAY |
| State | TN |
| Zip Code | 37615-6217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518307917 | Arissa Brooke Vaughn | Pharmacist | 5104 Bobby Hicks Hwy, Gray, TN 37615-6217 | 2013-06-28 |
| 1770923443 | Abigail Brown | Pharmacist | 5104 Bobby Hicks Hwy, Gray, TN 37615-6217 | 2013-06-26 |
| 1528379252 | Billie Reilly | Pharmacist | 5104 Bobby Hicks Hwy, Gray, TN 37615-6217 | 2010-06-28 |
| 1255642005 | Laura C Dinisio | Pharmacist | 5104 Bobby Hicks Hwy, Gray, TN 37615-6217 | 2010-06-27 |
| 1497066609 | Mandy Dishner | Pharmacist | 5104 Bobby Hicks Hwy, Gray, TN 37615-6217 | 2010-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568962983 | Clayton Kilgore | Pharmacist | 208 Suncrest St Unit 1, Gray, TN 37615 | 2018-02-13 |
| 1346648268 | Jesse Mullins | Pharmacist | 121 Boone Ridge Dr, Suite 1006, Johnson City, TN 37615 | 2014-12-09 |
| 1750650875 | Medical Education Assistance Corporation | Pediatrics | 252 Sam Jenkins Rd, Attn: Dr. H. Patrick Stern, Gray, TN 37615 | 2011-12-19 |
| 1700018603 | Anna Lynne Deal | Nurse Practitioner | 119 Boone Ridge Dr., Ste. 201, Johnson City, TN 37615 | 2009-08-11 |
| 1285876631 | Leigh A Furman | Occupational Therapist | 253 Wiltshire Dr., Gray, TN 37615 | 2009-04-01 |
| 1811098908 | Fay Lynn Bembry | Nurse Practitioner | 119 Boone Ridge Drive Ste. 201, Johnson City, TN 37615 | 2006-09-25 |
| 1871528976 | Boones Creek Medical Pllc | Family Medicine | 2685 Boones Creek Road, Suite 104, Johnson City, TN 37615 | 2006-07-11 |
| 1568402048 | Joseph Vincent Pinyard Jr. | Family Medicine | 880 Boones Station Rd, Johnson City, TN 37615 | 2006-06-07 |
| 1548223084 | Pitchar Theerathorn | Internal Medicine | 119 Boone Ridge Drive, Suite 201, Johnson City, TN 37615 | 2006-04-07 |
| 1194717157 | Susan Kay Pennypacker | Nurse Practitioner | 140 Old Gray Station Rd, Suite 200, Gray, TN 37615 | 2005-08-16 |
| Find all providers in zip 37615 | ||||
| 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 |
|---|---|---|---|---|
| 1366469843 | K Va T Food Stores Inc | Pharmacy | 125 Judge Gresham Rd, Gray, TN 37615-6213 | 2006-07-17 |
| 1003884248 | Gray Drug Co Inc | Pharmacy | 157 Bill Conn Pkwy, Gray, GA 31032-6349 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184223984 | Ramila, LLC | Pharmacy | 2652, Old Nashville Hwy, Mcminnville, TN 37110 | 2020-10-22 |
| 1063027258 | Aspire Pharmacy LLC | Pharmacy | 907 Rivergate Pkwy # E9, Goodlettsville, TN 37072-2324 | 2020-09-14 |
| 1003436049 | Frances Freeman | Pharmacy | 502 Maplewood Dr, Greenbrier, TN 37073-4638 | 2020-04-20 |
| 1740809292 | Kerri Elizabeth Jones | Pharmacy | 404 Red Cedar Branch Rd, Kingsport, TN 37664-5049 | 2020-04-14 |
| 1073149548 | Cordant Pharmacy Tennessee, LLC | Pharmacy | 640 Spence Ln Ste 220, Nashville, TN 37217-1278 | 2020-03-17 |
| 1538793567 | Fpm LLC | Pharmacy | 6078 S 1st St, Milan, TN 38358-3131 | 2020-02-28 |
| 1730727843 | Publix Tennessee, LLC | Pharmacy | 2223 8th Ave S, Nashville, TN 37204-2205 | 2019-12-19 |
| 1447897483 | Palmer Drug, LLC | Pharmacy | 9971 Sr 56, Coalmont, TN 37313-3731 | 2019-12-10 |
| 1013553155 | Vanderbilt University Medical Center | Pharmacy | 1211 Medical Center Dr # 2906, Nashville, TN 37232-0004 | 2019-11-25 |
| 1003450370 | Shreeya Drugs Inc | Pharmacy | 801 Broad St Ste 100, Chattanooga, TN 37402-2624 | 2019-10-30 |
| 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.