WALGREEN CO (NPI# 1720229511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720229511 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #12621 |
| Practice Address |
12955 Brown Bridge Rd Covington GA 30016-2905 |
| Mailing Address |
1901 E Voorhees St Ms #790 Danville IL 61834-4509 |
| Practice Telephone | 7703853226 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2016-08-29 |
| 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 | PHRE009572 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 121097837A | 05 | |
| NCPDP | 1158472 | 01 |
| Other Name | Type Code |
|---|---|
| WALGREENS #12621 | 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 |
12955 BROWN BRIDGE RD |
| City | COVINGTON |
| State | GA |
| Zip Code | 30016-2905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822802 | Nidhi Bhalesh Gandhi | Pharmacist | 12955 Brown Bridge Rd, Covington, GA 30016-2905 | 2020-08-21 |
| 1649552357 | Voncille Demesa | Pharmacist | 12955 Brown Bridge Rd, Covington, GA 30016-2905 | 2011-09-20 |
| 1356623334 | Sonal Patel | Pharmacist | 12955 Brown Bridge Rd, Covington, GA 30016-2905 | 2011-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013565605 | Katrina Williams | Case Manager/Care Coordinator | 220 Meadowidge Dr, Covington, GA 30016 | 2019-08-28 |
| 1407322134 | Mali Rice | Registered Nurse | 105 Syracuse Lane, Covington, GA 30016 | 2018-10-20 |
| 1619452927 | Angelina Jones | Contractor | 290 Piedmont Circle, Covington, GA 30016 | 2018-10-02 |
| 1881116721 | Springhill Manor Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 600 Spring Hill Drive, Covington, GA 30016 | 2017-07-12 |
| 1922538529 | Tisha Owes | Home Health | 110 Trinity Dr, Covington, GA 30016 | 2017-06-15 |
| 1053868695 | Delhia Assanah IIi | Counselor | 101 Kirkland Road, Covington, GA 30016 | 2016-09-01 |
| 1760834295 | Resurgens East Surgery Center, LLC | Clinic/Center | 3241 Iris Dr, Suite 100, Covington, GA 30016 | 2016-07-08 |
| 1528443371 | Latoya N Wright | Counselor | 100 Winnstead Place, Covington, GA 30016 | 2015-07-22 |
| 1598157307 | Sierra Private Homecare, Inc. | Adult Companion | 75 Cinnamon Oak Circle, Covington, GA 30016 | 2015-03-03 |
| 1326391079 | Lana Abiola Fraser | Nurse's Aide | 840 Oakhill Road, Covington, GA 30016 | 2012-10-18 |
| Find all providers in zip 30016 | ||||
| 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 |
|---|---|---|---|---|
| 1457723074 | Covington Multicare Hospital Pharmacy | Pharmacy | 17700 Se 272nd St Ste 100, Covington, WA 98042-4951 | 2015-10-22 |
| 1487058004 | Layton Pharmacy L.L.C. | Pharmacy | 70457 Highway 21 Ste 118, Covington, LA 70433-8155 | 2014-10-09 |
| 1730594870 | Carmichaels of Covington, Inc. | Pharmacy | 9148 Highway 278 Ne Ste D, Covington, GA 30014-7032 | 2014-06-27 |
| 1952647943 | Bradford Pharmacy LLC | Pharmacy | 1500 Highway 51 S, Covington, TN 38019-3212 | 2012-12-19 |
| 1972651974 | Braswell Drugs Inc | Pharmacy | 1107 S Tyler St, Covington, LA 70433-2327 | 2007-01-08 |
| 1497815989 | Pharmacy Operations, Inc | Pharmacy | 1000 Business 190, Covington, LA 70433-3285 | 2006-12-12 |
| 1467479592 | Walmart Inc. | Pharmacy | 17432 Se 270th Pl, Covington, WA 98042-4962 | 2006-07-16 |
| 1962427898 | Richardsons Pharmacy Inc | Pharmacy | 4104 Tate St, Covington, GA 30014-2551 | 2006-07-13 |
| 1780609339 | The Great Atlantic and Pacific Tea Company Inc | Pharmacy | 50 Park Place Dr, Covington, LA 70433-5183 | 2006-07-13 |
| 1780615815 | K Mart Corp | Pharmacy | 129 Mall Rd, Covington, VA 24426-2413 | 2006-07-06 |
| Find all providers in COVINGTON | ||||
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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.