WALGREEN CO (NPI# 1114932340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114932340 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #07111 |
| Practice Address |
1207 W Broadway Ave Forest Lake MN 55025-1418 |
| Mailing Address |
1901 E Voorhees St Ms 720 Danville IL 61834-4509 |
| Practice Telephone | 6512551884 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2015-12-22 |
| 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 | 262334 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 173462800 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2425557 | 01 |
| Other Name | Type Code |
|---|---|
| WALGREENS #07111 | 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 |
1207 W BROADWAY AVE |
| City | FOREST LAKE |
| State | MN |
| Zip Code | 55025-1418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033592019 | Nathan Bahr | Pharmacist | 1207 W Broadway Ave, Forest Lake, MN 55025-1418 | 2015-07-08 |
| 1629355409 | Chestevia Gibson | Pharmacist | 1207 W Broadway Ave, Forest Lake, MN 55025-1418 | 2011-11-08 |
| 1770868770 | Erin Michelle Arnold | Pharmacist | 1207 W Broadway Ave, Forest Lake, MN 55025-1418 | 2011-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043846173 | Persistence Physical Therapy LLC | Clinic/Center | 2009 W Broadway Ave, Ste 400 Pmb 131, Forest Lake, MN 55025 | 2020-03-20 |
| 1255973319 | Connie Rettig | Technician | 908 North Shore Drive, Forest Lake, MN 55025 | 2019-10-10 |
| 1003394479 | Malissa Ann Costanzo | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 844 8th Ave Se, Forest Lake, MN 55025 | 2018-07-30 |
| 1669754735 | Brent Alan Millard | Pharmacist | 1207 West Broadway Ave, Forest Lake, MN 55025 | 2011-09-15 |
| 1982842167 | Lakes Center for Youth and Families | Community/Behavioral Health | 20 N Lake Street, Suite 103, Forest Lake, MN 55025 | 2009-01-27 |
| 1487843355 | Paul Luke Mladnick | Marriage & Family Therapist | 1068 So Lake St, #109, Forest Lake, MN 55025 | 2007-10-17 |
| 1740477678 | Rita Lynn Scanlan | Occupational Therapist | 604 Ne 1st St, Birchwood Health Care Center, Forest Lake, MN 55025 | 2007-09-25 |
| 1114053113 | Senior Care Forest Lake, LLC | Skilled Nursing Facility | 604 N.e. First Street, Forest Lake, MN 55025 | 2007-02-26 |
| 1073672101 | Catharine B Ruther | Dentist | 956 West Broadway, Lakes Dental Clinic, Forest Lake, MN 55025 | 2006-12-06 |
| 1407914849 | Ervin George Savord | Dentist | 255 Highway 97, Suite 1b, Forest Lake, MN 55025 | 2006-12-05 |
| Find all providers in zip 55025 | ||||
| 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 |
|---|---|---|---|---|
| 1801813290 | Walmart Inc. | Pharmacy | 200 12th St Sw, Forest Lake, MN 55025-1482 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861033276 | Nina Marie Kleinschmidt | Pharmacy | 1315 Minnesota Ave, Detroit Lakes, MN 56501-3913 | 2019-10-07 |
| 1659837698 | Bpoint Pharmacy Services Ltd | Pharmacy | 30833 North Star Dr, Suite 2, Breezy Point, MN 56472 | 2019-02-14 |
| 1477042372 | Sanford Clinic North | Pharmacy | 1611 Anne St Nw Ste 1, Bemidji, MN 56601-5114 | 2018-05-07 |
| 1295222909 | A & E Pharmacy LLC | Pharmacy | 1509 10th Ave S, Minneapolis, MN 55404-1754 | 2018-04-18 |
| 1215445085 | Genoa Healthcare LLC | Pharmacy | 8441 Wayzata Blvd, Suite 340, Golden Valley, MN 55426-1372 | 2018-01-16 |
| 1497279608 | Coborns Inc | Pharmacy | 110 1st St S Ste B, Sauk Rapids, MN 56379-1404 | 2017-07-29 |
| 1740711753 | Hennepin Healthcare System Inc | Pharmacy | 800 Washington Ave N Ste 190, Minneapolis, MN 55401-1330 | 2017-03-22 |
| 1568903532 | First Choice Pharmacy of Jordan PC | Pharmacy | 165 West Commerce Drive, Suite 110, Belle Plaine, MN 56011 | 2017-03-10 |
| 1013454545 | Genesis Recovery Services, LLC | Pharmacy | 5 N 3rd Ave W Ste 302, Duluth, MN 55802-1614 | 2017-01-23 |
| 1104360973 | Group Health Plan, Inc. | Pharmacy | 3800 Park Nicollet Blvd Ste 1170, St Louis Park, MN 55416-2527 | 2016-12-13 |
| Find all providers with the same taxonomy | ||||
| City | FOREST LAKE |
| Zip Code | 55025 |
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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.