WALGREEN CO (NPI# 1073520060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073520060 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #06053 |
| Practice Address |
3990 24th Ave Port Huron MI 48060-1527 |
| Mailing Address |
1901 E Voorhees St Mailstop #790 Danville IL 61834-4509 |
| Practice Telephone | 8109874621 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2015-11-30 |
| 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 | 5301007195 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4809652 DME | 05 | |
| MI | 2361260 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2361260 | 01 |
| Other Name | Type Code |
|---|---|
| WALGREENS #06053 | 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 |
3990 24TH AVE |
| City | PORT HURON |
| State | MI |
| Zip Code | 48060-1527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861876781 | Cheryl Miller | Pharmacist | 3990 24th Ave, Port Huron, MI 48060-1527 | 2015-07-10 |
| 1255618609 | Anne Marie Ange | Pharmacist | 3990 24th Ave, Port Huron, MI 48060-1527 | 2011-11-14 |
| 1225315997 | Darouny Ann Sonsynath | Pharmacist | 3990 24th Ave, Port Huron, MI 48060-1527 | 2011-11-09 |
| 1275819856 | Matthew A Taylor | Pharmacist | 3990 24th Ave, Port Huron, MI 48060-1527 | 2011-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897297 | Casey Edward Bicker | Behavior Technician | 3245 Keewahdin Rd; Fort Gratiot, Mi 48059, Port Huron, MI 48060 | 2020-09-29 |
| 1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
| 1982123006 | Kenneth Shine Heuvelman | Counselor | 3522 Holland Park Ln, Port Huron, MI 48060 | 2017-09-11 |
| 1346767506 | Kelly Baker | Social Worker | 520 Superior St., Port Huron, MI 48060 | 2017-08-28 |
| 1326418609 | Jean Burleigh | Chore Provider | 614 Staton, Port Huron, MI 48060 | 2015-09-30 |
| 1205242161 | Lisa Gray | Counselor | 2885 W Rick Dr, Port Huron, MI 48060 | 2014-07-10 |
| 1861758880 | Aaron Overly | Surgery | 2609 Electric Ave Ste B&, Port Huron, MI 48060 | 2012-04-03 |
| 1942591508 | S Akram Ali | Surgery | 3270 Waldheim Dr, Port Huron, MI 48060 | 2011-04-29 |
| 1417258179 | Nicholas Alexander Tobianski | Physician Assistant | 3550 Pine Grove Avenue, Port Huron, MI 48060 | 2010-11-11 |
| 1598092769 | Blue Water Pharmacy LLC | Pharmacy | 1524 10th Street, Port Huron, MI 48060 | 2009-11-10 |
| Find all providers in zip 48060 | ||||
| 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 |
|---|---|---|---|---|
| 1568091957 | Blue Water Pharmacy LLC | Pharmacy | 1524 10th Street, Port Huron, MI 48060 | 2020-04-07 |
| 1174617393 | Visiting Nurse Services of Michigan | Pharmacy | 1221 Pine Grove Ave, Port Huron, MI 48060-3511 | 2006-10-03 |
| 1184657884 | Prime Healthcare Services-port Huron LLC | Pharmacy | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2006-07-08 |
| 1316978307 | Kmart of Michigan Inc | Pharmacy | 1179 32nd St, Port Huron, MI 48060-7363 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961763 | Dustyn Daniel Thoney | Pharmacy | 530 Harding Ave, Iron River, MI 49935-2265 | 2020-10-27 |
| 1497355697 | Katherine Jane Cybulski | Pharmacy | 1310 Waukazoo St, Hastings, MI 49058-9559 | 2020-10-27 |
| 1043836042 | Hanan Pharmacy LLC | Pharmacy | 4600 E 14 Mile Road, Suite 2, Warren, MI 48092-1057 | 2020-06-25 |
| 1770104192 | Hazelwood Pharmacy LLC | Pharmacy | 624 E 9 Mile Rd Ste C, Hazel Park, MI 48030-1842 | 2020-04-27 |
| 1457980609 | Berkley Pharmacy LLC | Pharmacy | 28577 Schoenherr Road, Warren, MI 48088 | 2020-04-08 |
| 1669012316 | Warriors Pharmacy, Inc. | Pharmacy | 5265 Anthony Wayne Dr, Detroit, MI 48202-3947 | 2020-01-10 |
| 1457996662 | Sunrise Pharmacy, LLC | Pharmacy | 989 University Dr Ste 104, Pontiac, MI 48342-1885 | 2019-11-12 |
| 1447894019 | Nova Pharmacy | Pharmacy | 15140 Levan Rd, Suite 40, Livonia, MI 48154 | 2019-11-06 |
| 1912541673 | Wayne Pharma | Pharmacy | 974 Ford Ave, Wyandotte, MI 48192 | 2019-11-05 |
| 1639720667 | Grand Haven Pharmacy LLC | Pharmacy | 930 John R Rd Ste Pharmacy, Troy, MI 48083-4316 | 2019-09-20 |
| Find all providers with the same taxonomy | ||||
| City | PORT HURON |
| Zip Code | 48060 |
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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.