WALGREEN CO (NPI# 1992710016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992710016 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #05095 |
| Practice Address |
1964 Fuller Ave Ne Grand Rapids MI 49505-4861 |
| Mailing Address |
1901 E Voorhees St Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 6163647078 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2015-11-24 |
| 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 | 5301006976 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4086255 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2359657 | 01 | |
| MI | 4808646 DME | 05 |
| Other Name | Type Code |
|---|---|
| WALGREENS #05095 | 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 |
1964 FULLER AVE NE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49505-4861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710508502 | Trevor Schulte | Pharmacist | 1964 Fuller Ave Ne, Grand Rapids, MI 49505-4861 | 2020-05-03 |
| 1497024996 | Eva Marie Kasbohm | Pharmacist | 1964 Fuller Ave Ne, Grand Rapids, MI 49505-4861 | 2011-12-29 |
| 1134405350 | Jessi Lynn Sedlacek | Pharmacist | 1964 Fuller Ave Ne, Grand Rapids, MI 49505-4861 | 2011-11-02 |
| 1225319627 | Earl Arthur Thompson IIi | Pharmacist | 1964 Fuller Ave Ne, Grand Rapids, MI 49505-4861 | 2011-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285276097 | Molly Beth Kerkstra | Home Health Aide | 1115 Ball Ave Nw, Grand Rapids, MI 49505 | 2019-10-14 |
| 1154849677 | Roshawn Nichol Whitley | Technician | 891 Maryland Ave, Grand Rapids, MI 49505 | 2017-09-05 |
| 1447778923 | Kelly Benzin-brinks | Social Worker | 1965 3 Mile Rd Ne, Grand Rapids, MI 49505 | 2017-09-05 |
| 1033560404 | Taylor Nolan Boyd | Speech-Language Pathologist | 400 Ann St Ne Ste 106a, Grand Rapids, MI 49505 | 2016-06-28 |
| 1023465002 | Calvin Athy | Counselor | 1101 Ballave Ne, Grand Rapids, MI 49505 | 2016-05-19 |
| 1821456682 | Kelly Van Huisen | Counselor | 1115 Ball Avenue Ne, Building B, Grand Rapids, MI 49505 | 2016-02-08 |
| 1780051102 | Mark Squeteri | Social Worker | 1345 Monroe Ave Nw Ste 234, Grand Rapids, MI 49505 | 2015-09-02 |
| 1346637337 | Shelby Fullington | Social Worker | 1011 Ball Ave Ne, Grand Rapids, MI 49505 | 2015-04-17 |
| 1457745325 | Lester Anderson II | Social Worker | 1115 Ball Ave, Grand Rapids, MI 49505 | 2015-03-27 |
| 1730570151 | Nicole Brown | Counselor | 1345 Monroe Ave Nw Ste 204, Grand Rapids, MI 49505 | 2015-02-06 |
| Find all providers in zip 49505 | ||||
| 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 |
|---|---|---|---|---|
| 1447746508 | Vincent Albert Patchett | Pharmacy | 800 Leonard St Nw Apt 115, Grand Rapids, MI 49504-4148 | 2018-07-02 |
| 1700321551 | Trinity Health-michigan | Pharmacy | 360 Division Ave S Ste 1e, Grand Rapids, MI 49503-4501 | 2017-01-04 |
| 1447668843 | Cet Pharmacy Ltc LLC | Pharmacy | 6140 28th St Se Ste 105, Grand Rapids, MI 49546-6938 | 2014-07-29 |
| 1588963706 | Ltc Pharmacy LLC | Pharmacy | 1314 Leonard St Nw, Grand Rapids, MI 49504-2937 | 2011-03-28 |
| 1225352909 | Kentwood Pharmacy LLC | Pharmacy | 2026 Boston St. Se, Grand Rapids, MI 49506 | 2010-03-24 |
| 1285963611 | Great Lakes Rph Corp | Pharmacy | 2500 E Beltline Ave Se Ste O, Grand Rapids, MI 49546-5987 | 2009-12-14 |
| 1083752075 | J & L Urevig Inc | Pharmacy | 124 Ne 4th St, Grand Rapids, MN 55744-2840 | 2007-02-02 |
| 1093704371 | Fulton Pharmacy Inc | Pharmacy | 738 W Fulton St, Grand Rapids, MI 49504-6320 | 2005-10-19 |
| 1790391613 | Mohamad Sheikh-khalil | Pharmacy | 550 Cherry St Se, Grand Rapids, MI 49503-4748 | 2020-09-16 |
| 1902379159 | Grand Itasca Clinic and Hospital | Pharmacy | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-01-09 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49505 |
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.