WALGREEN CO NPI 1265515670

NPI Information

NPI: 1265515670
Provider Name: WALGREEN CO
Classification: Pharmacy - 333600000X
Entity Type: Organization
Doing Business As: WALGREENS #15361
CLIA Number: 04D2058918
Address: 2503 W 28TH AVE
PINE BLUFF, AR
ZIP 71603
Phone: (870) 850-6084

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NPI Details

WALGREEN CO is a pharmacy in Pine Bluff, 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 1265515670. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens #15361.

The provider's business location address is:

2503 W 28TH AVE
PINE BLUFF, AR
ZIP 71603-053
Phone: (870) 850-6084
Fax: (870) 850-6361

The provider's authorized official is Kira 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 04D2058918 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/23/2006 and was last updated on 4/28/2022.

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
1	332B00000X	Durable Medical Equipment & Medical Supplies				No
2	3336C0003X	Pharmacy	Community/Retail Pharmacy			No
3	333600000X	Pharmacy		AR20702	ARKANSAS	Yes

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
1	127143716	OTHER		MEDICAID DME
2	100633407	MEDICAID	ARKANSAS
3	10619	OTHER	ARKANSAS	MEDICARE FLU
4	0409450	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

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: 3/30/2025

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