WALGREEN CO (NPI# 1134134380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134134380 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #05813 |
| Practice Address |
11930 Standiford Plaza Dr Louisville KY 40229-5901 |
| Mailing Address |
1901 E Voorhees St Ms #790 Danville IL 61834-4509 |
| Practice Telephone | 5029615840 |
| Practice Fax Number | 5029615847 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2015-11-26 |
| 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 | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | P06600 | KY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1826378 | 01 | |
| KY | 5400133400 | 05 |
| Other Name | Type Code |
|---|---|
| WALGREENS #05813 | 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 |
11930 STANDIFORD PLAZA DR |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40229-5901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710592134 | Casey Dettlinger | Pharmacist | 11930 Standiford Plaza Dr, Louisville, KY 40229-5901 | 2020-09-11 |
| 1457965881 | Wesley Leo Thomas | Pharmacist | 11930 Standiford Plaza Dr, Louisville, KY 40229-5901 | 2020-09-02 |
| 1295016509 | Derrick Greenwell | Pharmacist | 11930 Standiford Plaza Dr, Louisville, KY 40229-5901 | 2011-08-31 |
| 1548540032 | Thomas Joseph Genardi | Pharmacist | 11930 Standiford Plaza Dr, Louisville, KY 40229-5901 | 2011-08-28 |
| 1285914721 | James David Mullins | Pharmacist | 11930 Standiford Plaza Dr, Louisville, KY 40229-5901 | 2011-08-27 |
| 1558641183 | James B Bertrand | Pharmacist | 11930 Standiford Plaza Dr, Louisville, KY 40229-5901 | 2011-08-26 |
| 1861772519 | Micah Thompson | Pharmacist | 11930 Standiford Plaza Dr, Louisville, KY 40229-5901 | 2011-08-26 |
| 1508146168 | Samuel Travis Timberlake | Pharmacist | 11930 Standiford Plaza Dr, Louisville, KY 40229-5901 | 2011-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104341171 | Brandy Wells | Family Medicine | 11612 Top Walnut Loop, Louisville, KY 40229 | 2017-08-10 |
| 1649472655 | Janice K Jones | Physical Therapy Assistant | 5111 Commerce Crossing Suite 100, Louisville, KY 40229 | 2007-06-01 |
| 1528102183 | R Douglas Edwards Jr. | Dentist | 3807 Freedom Way, Louisville, KY 40229 | 2007-02-16 |
| 1407833940 | Robert D Bretz | Radiology | 879 Old Preston Highway North, Louisville, KY 40229 | 2005-12-27 |
| 1134606619 | Brynn Ashley Dombroski | Behavioral Analyst | 5215 Commerce Crossings Dr, Louisville, KY 40229 | 2018-07-26 |
| 1669972923 | Mariah Evelyn Laird | Occupational Therapist | 5215 Commerce Crossings Dr, Louisville, KY 40229 | 2018-02-13 |
| 1992219174 | Noelle Allison Lang | Anesthesiology | 11901 Standiford Plaza Dr, Louisville, KY 40229 | 2017-11-26 |
| 1134664949 | Jessica Ann Mattingly | Nurse Practitioner | 170 Dr Arla Way, Louisville, KY 40229 | 2017-01-03 |
| 1356727929 | Meredith Kyle-alvey Luckett | Physical Therapist | 170 Dr Arla Way, Louisville, KY 40229 | 2015-08-06 |
| 1861688459 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 9500 Preston Hwy, Louisville, KY 40229-1166 | 2007-09-18 |
| Find all providers in zip 40229 | ||||
| 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 |
|---|---|---|---|---|
| 1942791231 | Patek Pharmacy LLC | Pharmacy | 8600 Preston Hwy, Louisville, KY 40219-5306 | 2018-05-23 |
| 1831540368 | Cordant Pharmacy Kentucky LLC | Pharmacy | 10503 Timberwood Cir Ste 202, Louisville, KY 40223-5395 | 2016-06-27 |
| 1386099661 | Costco Wholesale Corporation | Pharmacy | 3408 Bardstown Rd, Louisville, KY 40218 | 2016-04-25 |
| 1316307994 | Jac Stores Inc | Pharmacy | 326 Route 45 N, Louisville, IL 62858-2652 | 2016-02-25 |
| 1750750394 | My Rx LLC | Pharmacy | 170 Dr Arla Way Ste 105, Louisville, KY 40229-5454 | 2015-09-23 |
| 1871972620 | Jag Medical LLC | Pharmacy | 9813 Merioneth Dr, Louisville, KY 40299 | 2015-05-27 |
| 1215331293 | Shri Siddi Vinayaka Drugs Inc | Pharmacy | 322 W Woodlawn Ave, Louisville, KY 40214-1924 | 2014-10-20 |
| 1316285661 | Cpo Psc | Pharmacy | 4402 Churchman Ave Ste 404, Louisville, KY 40215-3102 | 2013-01-22 |
| 1588931836 | Panniche Compounding, Ltd Co | Pharmacy | 5703 Preston Hwy, Louisville, KY 40219-1305 | 2011-11-30 |
| 1104027978 | Holdaway Medical Services, LLC | Pharmacy | 11305 Bluegrass Pkwy, Louisville, KY 40299-2347 | 2007-05-30 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40229 |
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.