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WALGREEN CO NPI 1174538284


NPI Information

NPI: 1174538284
Provider Name: WALGREEN CO

Doing Business As: WALGREENS #15007

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 23D2059229

Address:
425 FULLER AVE NE
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 776-9925
Get Directions

WALGREEN CO is a pharmacy in Grand Rapids, MI. 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 1174538284. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens #15007.

The provider's business location address is:

425 FULLER AVE NE
GRAND RAPIDS, MI
ZIP 49503-911
Phone: (616) 776-9925

The provider's authorized official is Alan T Nielsen .
The authorized official title is Treasurer and has the following contact phone number (847) 315-3523.

The CLIA number assigned to this NPI record is 23D2059229 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/29/2006 and was last updated on 1/14/2016.


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
3333600000XPharmacy5301005824MICHIGANYes

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
10282931129MEDICARE NSCMICHIGAN
24808870 DMEMEDICAIDMICHIGAN
32898869MEDICAIDMICHIGAN
4P00400633MEDICARE PIN
52350825OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
6PHC049MEDICARE PINMICHIGAN

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.