WALGREEN CO (NPI# 1003086380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003086380 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS 09479 |
| Practice Address |
12387 Yellow Bluff Rd Jacksonville FL 32226-2025 |
| Mailing Address |
1901 E Voorhees St Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 9047512744 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2019-04-18 |
| Authorized Official Name | ALYSSA SWEETEN (MANAGER) |
| Authorized Official Telephone | 2177092386 |
| 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 | PH23375 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 032633002 | 05 | |
| FL | FL MEDICAID DME | 032633002 | 01 |
| FL | 000137200 | 05 | |
| NCPDP | 1033579 | 01 |
| Other Name | Type Code |
|---|---|
| WALGREENS 09479 | 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 |
12387 YELLOW BLUFF RD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32226-2025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342770 | Edward Horace Robinson Iv | Pharmacist | 12387 Yellow Bluff Rd, Jacksonville, FL 32226-2025 | 2020-10-08 |
| 1043823818 | Kelly Giang | Pharmacist | 12387 Yellow Bluff Rd, Jacksonville, FL 32226-2025 | 2020-08-31 |
| 1902418262 | Hannah Lynn Skipper | Pharmacist | 12387 Yellow Bluff Rd, Jacksonville, FL 32226 | 2020-08-18 |
| 1548692288 | Christina Whittaker | Pharmacist | 12387 Yellow Bluff Rd, Jacksonville, FL 32226-2025 | 2013-08-05 |
| 1003135096 | Mitesh R Patel | Pharmacist | 12387 Yellow Bluff Rd, Jacksonville, FL 32226-2025 | 2010-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851909501 | A1 Staffing, Inc | Acupuncturist | 17982 North Main Street, Jacksonvile, FL 32226 | 2020-07-20 |
| 1518422294 | Brittany Fennell | Dentist | 13201 New Berlin Rd, Jacksonville, FL 32226 | 2019-02-06 |
| 1922554252 | Debra Richards | Custodial Care Facility | 14121 Devan Lee Dr W, Jacksonville, FL 32226 | 2016-08-28 |
| 1750672333 | Kristen Duffney | Behavioral Analyst | 12665 White Cedar Trail, Jacksonville, FL 32226 | 2011-04-29 |
| 1780782466 | Alisha Stanford | Dentist | 3118 New Berlin Road, Suite 1, Jacksonville, FL 32226 | 2006-09-20 |
| 1760454037 | Christopher B Scuderi | Family Medicine | 3122 New Berlin Road, Uf New Berlin Family Medicin Center, Jacksonville, FL 32226 | 2006-02-02 |
| 1720500093 | Hope and A Future Ministries Inc | Counselor | 7334 Berry Ave, Jacksonville, FL 32226 | 2017-07-08 |
| 1942743430 | Sarah Larrabee | Behavioral Analyst | 13815 Devan Lee Dr E, Jacksonville, FL 32226 | 2016-12-01 |
| 1447350988 | Kristan David Podvia | Dentist | 3118 New Berlin Road, Suite 1, Jacksonville, FL 32226 | 2006-09-24 |
| 1568560118 | Podvia and Stanford Dmds | Dentist | 3118 New Berlin Road, Suite 1, Jacksonville, FL 32226 | 2006-09-20 |
| Find all providers in zip 32226 | ||||
| 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 |
|---|---|---|---|---|
| 1467954438 | De2 LLC | Pharmacy | 2624 Atlantic Blvd Ste 3, Jacksonville, FL 32207-3633 | 2018-03-06 |
| 1174037063 | Banyanites - 2 LLC | Pharmacy | 11048 Baymeadows Rd Unit 5, Jacksonville, FL 32256-9583 | 2017-11-30 |
| 1538600424 | Can Community Health Inc. | Pharmacy | 4615 Philips Hwy, Suite 3, Jacksonville, FL 32207-9506 | 2017-03-13 |
| 1871039701 | An&u Inc | Pharmacy | 1729 S Jackson St, Jacksonville, TX 75766-5832 | 2017-01-17 |
| 1114479821 | Trucare Ltc, LLC | Pharmacy | 2671 Huffman Blvd, Jacksonville, FL 32246-4056 | 2016-10-28 |
| 1083161038 | Cornerstone Pharmacy Jacksonville LLC | Pharmacy | 315 S James St, Jacksonville, AR 72076-4315 | 2016-09-07 |
| 1326591066 | Sprx2 Inc | Pharmacy | 1201 Monument Rd Ste 100, Jacksonville, FL 32225-6445 | 2016-07-29 |
| 1568822377 | Sprx Inc | Pharmacy | 3740 Saint Johns Bluff Rd S Ste 21, Jacksonville, FL 32224-2650 | 2016-03-07 |
| 1548648363 | Caremax Pharmacy 725 LLC | Pharmacy | 5547 Normandy Blvd, Jacksonville, FL 32205-6246 | 2015-05-13 |
| 1538563580 | Florida A and M University College of Pharmacy | Pharmacy | 2050 Art Museum Dr, Suite 200, Jacksonville, FL 32207-2595 | 2014-10-20 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32226 |
Please comment or provide details below to improve the information on WALGREEN CO.
| 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.