WALGREEN CO NPI 1134431620

NPI Information

  • NPI: 1134431620
  • Provider Name: WALGREEN CO
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Doing Business As: WALGREENS SPECIALTY PHARMACY #13979
  • CLIA Number: 44D2032537
  • Address: 1 MEDICAL PARK BLVD STE 106E
    BRISTOL, TN
    ZIP 37620
  • Phone: (423) 844-2888

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NPI Details

WALGREEN CO is a pharmacy in Bristol, TN. 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 1134431620. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens Specialty Pharmacy #13979.

The provider's business location address is:

1 MEDICAL PARK BLVD STE 106E
BRISTOL, TN
ZIP 37620-450
Phone: (423) 844-2888
Fax: (423) 844-0539

The provider's authorized official is Jennifer Ponce .
The authorized official title is Manager and has the following contact phone number (847) 527-2489.

The CLIA number assigned to this NPI record is 44D2032537 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count (HCPCS:K1034)

The enumeration date for this NPI number is 7/13/2010 and was last updated on 11/21/2024.

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
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyYes
33336C0003XPharmacyCommunity/Retail PharmacyNo

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
17100635050MEDICAIDKENTUCKY
24443406OTHERNCPDP

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: 11/21/2025

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