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WALGREEN CO. NPI 1174717045


NPI Information

NPI: 1174717045
Provider Name: WALGREEN CO.

Doing Business As: WALGREENS #9882

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 05D2223082

Address:
331 N PACIFIC COAST HWY
EL SEGUNDO, CA
ZIP 90245
Phone: (310) 640-9651
Get Directions

WALGREEN CO. is a pharmacy in El Segundo, CA. 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 1174717045. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens #9882.

The provider's business location address is:

331 N PACIFIC COAST HWY
EL SEGUNDO, CA
ZIP 90245-444
Phone: (310) 640-9651
Fax: (310) 414-9942

The provider's authorized official is Kira L 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 05D2223082 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/4/2007 and was last updated on 10/27/2023.


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
3333600000XPharmacyPHY48820CALIFORNIAYes

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
11174717045MEDICAIDCALIFORNIA
25628207OTHERNCPDP
3PHA488200MEDICAIDCALIFORNIA

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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