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WALGREEN CO NPI 1053640441


NPI Information

NPI: 1053640441
Provider Name: WALGREEN CO

Doing Business As: WALGREENS #12628

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 26D2053807

Address:
2001 S RANGE LINE RD
JOPLIN, MO
ZIP 64804
Phone: (417) 626-8553
Get Directions

WALGREEN CO is a pharmacy in Joplin, MO. The provider is 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. WALGREEN CO NPI is 1053640441. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens #12628.

The provider's business location address is:

2001 S RANGE LINE RD
JOPLIN, MO
ZIP 64804-240
Phone: (417) 626-8553
Fax: (417) 626-8766

The provider's authorized official is Kira Taylor .
The authorized official title is Manager and has the following contact phone number (217) 709-2351.

The CLIA number assigned to this NPI record is 26D2053807 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/14/2009 and was last updated on 4/5/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacy2010012806MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1606476406MEDICAIDMISSOURI
22638940OTHERNCPDP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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