Provider Type Icon

WALGREEN LOUISIANA CO INC NPI 1629084017


NPI Information

NPI: 1629084017
Provider Name: WALGREEN LOUISIANA CO INC

Doing Business As: WALGREENS #06219

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 19D2015516

Address:
2636 RYAN ST
LAKE CHARLES, LA
ZIP 70601
Phone: (337) 433-4178
Get Directions

WALGREEN LOUISIANA CO INC is a pharmacy in Lake Charles, LA. 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 LOUISIANA CO INC NPI is 1629084017. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens #06219.

The provider's business location address is:

2636 RYAN ST
LAKE CHARLES, LA
ZIP 70601-326
Phone: (337) 433-4178

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 19D2015516 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/31/2006 and was last updated on 11/30/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacy1166RCLOUISIANAYes

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
1690015MEDICAIDTEXAS
21242837MEDICAIDLOUISIANA
30437240008MEDICARE NSCLOUISIANA
4PHC095MEDICARE PIN
51900302OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
6P00792871MEDICARE PIN

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.