Walgreen Co.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

WALGREEN CO.

Doing business as

Walgreens #5720

Practice address

3601 16TH St
Moline, IL 61265-7259

Phone

(309) 797-5865

Fax

(309) 797-0622

NPI assigned

Jun 2, 2022

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 1

Addresses

Other names 1

• WALGREENS #5720 Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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

CLIA laboratory certificates

Part of

Walgreens Holding Company

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": "1654128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1063151587",
    "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": "3601 16TH ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657259",
            "telephone_number": "309-797-5865",
            "fax_number": "309-797-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN CO.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-05-23",
        "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 #5720",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brandon Michael Wainwright, DDS
• Wal-Mart Stores, Inc (Vision Center 30-2231)
• Walgreen Co (Walgreens #03633)
• Walgreen Co (Walgreens #5720)
• Walgreen Co (Walgreens #06067)
• Walgreen Co. (Walgreens #3633)
• Walgreen Co. (Walgreens #6067)
• Harry L. Wallace, D.C.
• Sarah Ade Wallace, DMD
• Harry R Wallner, M.D.

• Clinical Medical Laboratory in Moline, IL
• Providers in Moline, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.