Legal Business Name
Walgreen Co
Also Known As
Walgreens #03258
NPI Number
1407861461
NPI Type
Organization
Enumeration Date
07/29/2006
Specialties
(Taxonomies)Code
333600000X
3336C0003X
332B00000X
Primary Taxonomy
Yes
No
No
Licenses
State
Oklahoma
License Number
2-3852
Contact
Information
Purpose
Mailing
Location
Address
1901 E VOORHEES ST
4971 S MEMORIAL DR
City
Danville
Tulsa
State
IL
OK
Postal Code
61834-4509
74145-6914
Country
US
US
Telephone Number
(217) 709-2351
(918) 663-4578
Authorized Official
Name
Kira Taylor
Title or Position
MANAGER
Telephone Number
(217) 709-2351
Identifiers
Identifier
100793920A
100243120A
3719575
Identifier State
OK
OK
Unknown
Identifier Issuer
MEDICAID DME
Unknown
OTHER ID NUMBER-COMMERCIAL NUMBER
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 11/03/2023
Provider Address
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