NPIMap

Organization Active NPI

Walgreen Co.

  • Clinical Medical Laboratory
  • Shepherdstown, WV
National Provider Identifier
1033837331
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
WALGREEN CO.
Practice address
26 Maddex Square Dr
Shepherdstown, WV 25443-4321
Phone
(304) 876-0505
NPI assigned
Aug 22, 2022
Organization subpart
Yes
Parent organization
WALGREENS BOOTS ALLIANCE INCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Kira L Taylor
Title
Manager
Phone
(217) 709-2351

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2242641Walgreens #1970926 Maddex Square, Shepherdstown, WV 25443Certificate of waiverNov 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
Walgreen Co8,684 organizations share this tax ID, including this one
Part of
Walgreens Holding Company

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

26 Maddex Square Dr
Shepherdstown, WV 25443-4321

Mailing address

1901 E Voorhees St # Ms 790
Danville, IL 61834-4509
Phone (217) 709-2351

Other names 1

NPPES NPI Registry
  • Walgreens #19709 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2022.

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1033837331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST # MS 790",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618344509",
            "telephone_number": "217-709-2351",
            "fax_number": "217-709-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 MADDEX SQUARE DR",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "254434321",
            "telephone_number": "304-876-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN CO.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "KIRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "217-709-2351"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walgreens #19709",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shepherdstown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.