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WALGREEN CO NPI 1407091523


NPI Information

NPI: 1407091523
Provider Name: WALGREEN CO

Doing Business As: WALGREENS #12303

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 14D2044663

Address:
5939 BELLEVILLE CROSSING ST
BELLEVILLE, IL
ZIP 62226
Phone: (618) 355-7913
Get Directions

WALGREEN CO is a pharmacy in Belleville, IL. 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 1407091523. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens #12303.

The provider's business location address is:

5939 BELLEVILLE CROSSING ST
BELLEVILLE, IL
ZIP 62226-107
Phone: (618) 355-7913

The provider's authorized official is A 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 14D2044663 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/3/2008 and was last updated on 5/31/2017.


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
3333600000XPharmacy054.019138ILLINOISYes

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
1PHC049MEDICARE PIN
2P00400633MEDICARE PIN
31482746OTHERNCPDP
40282936860MEDICARE NSC
5=========161MEDICAIDILLINOIS

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.