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WALGREEN CO NPI 1194730457


NPI Information

NPI: 1194730457
Provider Name: WALGREEN CO

Doing Business As: WALGREENS #03412

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 04D2063053

Address:
5917 BASELINE RD
LITTLE ROCK, AR
ZIP 72209
Phone: (501) 565-7844
Get Directions

WALGREEN CO is a pharmacy in Little Rock, AR. 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 1194730457. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens #03412.

The provider's business location address is:

5917 BASELINE RD
LITTLE ROCK, AR
ZIP 72209-046
Phone: (501) 565-7844

The provider's authorized official is Lisa Badgley .
The authorized official title is Senior Vice President and has the following contact phone number (847) 315-3012.

The CLIA number assigned to this NPI record is 04D2063053 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/29/2006 and was last updated on 3/9/2022.


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
3333600000XPharmacy18764ARKANSASYes

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
1127407407MEDICAIDARKANSAS
2156947716 DMEMEDICAIDARKANSAS
30418764OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
4100130006MEDICAIDALABAMA

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: 11/14/2023

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