Walgreen Co.

Primary specialty

PharmacyTaxonomy code 333600000X

License

054.019040 Issued in IL

Legal business name

WALGREEN CO.

Practice address

1122 Vaughn Rd
Wood River, IL 62095-1848

Phone

(618) 259-2013

Fax

(618) 259-2098

NPI assigned

May 22, 2006

Organization subpart

Yes

Parent organization

WALGREENS BOOTS ALLIANCE INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kira L Taylor

Title

Manager

Phone

(217) 709-2351

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• WALGREENS #01996 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX, IL3 enrollments

Enrollment records 3

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

CLIA laboratory certificates

Medicare medical equipment & supply locations

Part of

Walgreens Holding Company

Member of 16

Organizations this organization is a member of, according to the National Provider Directory.

• Walgreen Co

  • Pharmacy
  • South Chicago Heights, IL
  • NPI 1538175096

  Member Of

  NPD member
• Walgreen Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • Mokena, IL
  • NPI 1215195730

  Member Of

  NPD member
• Cypress Home Medical Inc

  • Home Infusion Therapy Pharmacy
  • Fort Myers, FL
  • NPI 1437188315

  Member Of

  NPD member
• Healthcare Options of Minnesota, Inc.

  • Home Infusion Therapy Pharmacy
  • Sauk Rapids, MN
  • NPI 1891746111

  Member Of

  NPD member
• I.V. Associates, Inc.

  • Home Infusion Therapy Pharmacy
  • Eatontown, NJ
  • NPI 1811940810

  Member Of

  NPD member
• Mednow Infusion, LLC

  • Home Infusion Agency
  • Meridian, ID
  • NPI 1225645526

  Member Of

  NPD member
• Option Care at Legacy Health LLC

  • Home Infusion Therapy Pharmacy
  • Bend, OR
  • NPI 1174875017

  Member Of

  NPD member
• Option Care Enterprises, Inc.

  • Home Infusion Therapy Pharmacy
  • Chantilly, VA
  • NPI 1679896989

  Member Of

  NPD member
• Option Care Home Care, Inc.

  • Home Infusion Agency
  • Wauwatosa, WI
  • NPI 1396343471

  Member Of

  NPD member
• Option Care Infusion Services, LLC

  • Home Infusion Therapy Pharmacy
  • Nashville, TN
  • NPI 1326279746

  Member Of

  NPD member
• TSL Inc

  • Home Infusion Therapy Pharmacy
  • Merrillville, IN
  • NPI 1942269956

  Member Of

  NPD member
• Walgreen Co

  • Pharmacy
  • Wilmington, DE
  • NPI 1093738643

  Member Of

  NPD member

Locations

All facility ownership & control disclosures 77

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Walgreens Boots Alliance

  • Community/Retail Pharmacy
  • Wauconda, IL
  • NPI 1831978451
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1043264153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST",
            "address_2": "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": "1122 VAUGHN RD",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620951848",
            "telephone_number": "618-259-2013",
            "fax_number": "618-259-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN CO.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
        "enumeration_date": "2006-05-22",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "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": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": "054.019040",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1478747",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALGREENS #01996",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WALGREENS #01996",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The William M Bedell Achievement and Resource Center
• Hayley Ann Nicole Turner
• Jennifer Volle, HIS
• Wal-Mart Stores Inc
• Wal-Mart Stores, Inc
• Walgreen Co.
• Walmart Inc.
• Susan Lynn Way
• Barbara Well, BC-HIS
• Denise L West, LMSW

• Pharmacy in Wood River, IL
• Providers in Wood River, IL by specialty
• Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.