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WALGREEN CO NPI 1619103157


NPI Information

NPI: 1619103157
Provider Name: WALGREEN CO

Doing Business As: WALGREENS #13074

Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

CLIA Number: 52D2287446

Address:
900 ILLINOIS AVE
STEVENS POINT, WI
ZIP 54481
Phone: (715) 344-6834
Get Directions

WALGREEN CO is a clinic pharmacy pharmacy in Stevens Point, WI. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. WALGREEN CO NPI is 1619103157. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens #13074.

The provider's business location address is:

900 ILLINOIS AVE
STEVENS POINT, WI
ZIP 54481-114
Phone: (715) 344-6834

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 52D2287446 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/10/2009 and was last updated on 11/5/2015.


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
2333600000XPharmacy8917WISCONSINNo
33336C0002XPharmacyClinic PharmacyYes

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
11619103157MEDICAIDWISCONSIN
20282937206MEDICARE NSCWISCONSIN
35131610OTHERWISCONSINNCPDP
4P00400633MEDICARE PINWISCONSIN
51619103157OTHERWISCONSINWI DME
6PHC049MEDICARE PINWISCONSIN

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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