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WALGREEN CO NPI 1740295963


NPI Information

NPI: 1740295963
Provider Name: WALGREEN CO

Doing Business As: WALGREENS #03628

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 10D2232029

Address:
4204 PALM BEACH BLVD
FORT MYERS, FL
ZIP 33905
Phone: (239) 694-2114
Get Directions

WALGREEN CO is a pharmacy in Fort Myers, FL. 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 1740295963. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens #03628.

The provider's business location address is:

4204 PALM BEACH BLVD
FORT MYERS, FL
ZIP 33905-413
Phone: (239) 694-2114

The provider's authorized official is Lisa Badgley .
The authorized official title is Senior Vice President and has the following contact phone number (847) 315-3012.

The CLIA number assigned to this NPI record is 10D2232029 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/29/2006 and was last updated on 3/10/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0003XPharmacyCommunity/Retail PharmacyNo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
3333600000XPharmacyPH0013839FLORIDAYes

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
1103441301 DMEMEDICAIDFLORIDA
21077090OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
3103441300MEDICAIDFLORIDA

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.