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WALGREEN CO NPI 1083629018


NPI Information

NPI: 1083629018
Provider Name: WALGREEN CO

Doing Business As: WALGREENS #07901

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 26D2038841

Address:
1050 US HIGHWAY 60 E
REPUBLIC, MO
ZIP 65738
Phone: (417) 732-7829
Get Directions

WALGREEN CO is a pharmacy in Republic, 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 1083629018. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens #07901.

The provider's business location address is:

1050 US HIGHWAY 60 E
REPUBLIC, MO
ZIP 65738-569
Phone: (417) 732-7829

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 26D2038841 - 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 6/8/2022.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyNo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
3333600000XPharmacy2004010000MISSOURIYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1626122204OTHERMISSOURIDME
22635425OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
3606122208MEDICAIDMISSOURI

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: 5/5/2024

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