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WALGREEN CO NPI 1023281656


NPI Information

NPI: 1023281656
Provider Name: WALGREEN CO

Doing Business As: WALGREENS #11622

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 13D2034288

Address:
1725 1ST ST
IDAHO FALLS, ID
ZIP 83401
Phone: (208) 419-4684
Get Directions

WALGREEN CO is a pharmacy in Idaho Falls, ID. 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 1023281656. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens #11622.

The provider's business location address is:

1725 1ST ST
IDAHO FALLS, ID
ZIP 83401-306
Phone: (208) 419-4684
Fax: (208) 419-4690

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 13D2034288 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/3/2008 and was last updated on 11/1/2023.


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
3333600000XPharmacy38585RPIDAHOYes

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
1808108200 DMEMEDICAIDIDAHO
2808073100MEDICAIDIDAHO
31307885OTHERNCPDP

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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