WALGREEN CO (NPI# 1003041674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003041674 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #12744 |
| Practice Address |
108 S Poplar St Pana IL 62557-1404 |
| Mailing Address |
1901 E Voorhees St M/s 790 Danville IL 61834-4509 |
| Practice Telephone | 2175622770 |
| Mailing Telephone | 2177092386 |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2016-01-13 |
| 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 | 054.016692 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 1483368 | 01 |
| Other Name | Type Code |
|---|---|
| WALGREENS #12744 | 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 |
108 S POPLAR ST |
| City | PANA |
| State | IL |
| Zip Code | 62557-1404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932713542 | Yao Wang | Pharmacist | 108 S Poplar St, Pana, IL 62557-1404 | 2020-09-01 |
| 1144832973 | Clayton Whittington | Pharmacist | 108 S Poplar St, Pana, IL 62557-1404 | 2020-08-22 |
| 1720410160 | Michelle Dianne Foreman | Pharmacist | 108 S Poplar St, Pana, IL 62557-1404 | 2013-08-08 |
| 1598042954 | Megan Bertolino | Pharmacist | 108 S Poplar St, Pana, IL 62557-1404 | 2011-11-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033567805 | Joni Marie Lidy | Speech-Language Pathologist | 1000 E. 6th Street, Pana, IL 62557 | 2016-06-01 |
| 1750538237 | Nancy L. Simpson | Physical Therapy Assistant | 100 E 6th St. Rd., Pana, IL 62557 | 2008-08-26 |
| 1306093661 | Maiden Louise Axalan Bacolod | Physical Therapist | 900 S Chestnut, Prairie Rose Healthcare Center, Pana, IL 62557 | 2008-08-19 |
| 1922128123 | Randall Dean Floyd | Dentist | 9 South State Street, Pana, IL 62557 | 2007-03-30 |
| 1114056363 | Laurie Cunnington | Family Medicine | 101 East Ninth St, Pana, IL 62557 | 2007-03-05 |
| 1871688390 | Donald Metzger | Pharmacist | 28 East Second, Pana, IL 62557 | 2006-10-03 |
| 1851486377 | John A Metzger | Pharmacist | 28 East Second Street, Pana, IL 62557 | 2006-10-03 |
| 1437228319 | Deogracias F Quizon | Family Medicine | 217 S Locust St, Pana Medical Group LLC, Pana, IL 62557 | 2006-11-07 |
| 1235225236 | Pana Community Hospital Association | Clinic/Center | 101 E 9th St, Suite 105, Pana, IL 62557 | 2006-10-05 |
| 1245437797 | Hickory Estates of Pana LLC | Assisted Living Facility | 101 N Hickory St, Pana, IL 62557-1040 | 2007-06-28 |
| Find all providers in zip 62557 | ||||
| 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 |
|---|---|---|---|---|
| 1730702549 | Aster Pharmacy LLC | Pharmacy | 9213 Waukegan Rd, Morton Grove, IL 60053-2102 | 2020-05-27 |
| 1568083301 | Pointcore, Inc. | Pharmacy | 1800 N Knoxville Ave Ste G, Peoria, IL 61603-3028 | 2020-05-04 |
| 1336768001 | Mhg Pharmacy Services, LLC | Pharmacy | 2923 N California Ave Ste 240, Chicago, IL 60618-7702 | 2020-04-13 |
| 1184258824 | Metropolitian Austin Outpatient Pharmacy LLC | Pharmacy | 645 S Central Ave Ste 1, Chicago, IL 60644-5059 | 2020-03-02 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1568093615 | Carefirst Pharmacy, Inc. | Pharmacy | 2253 N Cicero Ave, Chicago, IL 60639-3327 | 2020-01-28 |
| 1720624521 | Affinity Pharmacy Care LLC | Pharmacy | 285 W Loop Rd Ste 1, Wheaton, IL 60189-2036 | 2019-11-27 |
| 1104462126 | Loyola University Medical Center | Pharmacy | 2160 S 1st Ave Rm 150-1610, Maywood, IL 60153-3328 | 2019-11-25 |
| 1346886512 | Value Plus Pharmacy LLC | Pharmacy | 457 W Liberty St, Wauconda, IL 60084-2452 | 2019-11-22 |
| 1841833100 | April M Bailey | Pharmacy | 1019 Oakcrest Dr, Rantoul, IL 61866-1118 | 2019-10-18 |
| 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.