Organization Active NPI

Walgreen Co

Doing business as Walgreens #10522

  • Pharmacy
  • Houston, TX
National Provider Identifier
1144235235
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
24591 Issued in TX
Legal business name
WALGREEN CO
Doing business as
Walgreens #10522
Practice address
7777 Southwest Fwy Ste 104
Houston, TX 77074-1805
Phone
(713) 270-0632
Fax
(713) 270-5263
NPI assigned
Jul 29, 2006
Last updated
May 21, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
WALGREENS BOOTS ALLIANCE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Authorized official

Name
Alyssa Sweeten
Title
Manager
Phone
(217) 709-2386

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X 24591 TX Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

7777 Southwest Fwy Ste 104
Houston, TX 77074-1805

Mailing address

1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 709-2386

Other identifiers 3

IdentifierTypeStateIssuer
466257MedicaidTX
470853MedicaidTX
4539853OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • WALGREENS #10522 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070917000779 TX Part B Supplier - Centralized Flu Biller 0941278253 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Walgreens Holding Company

Member of 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558396800000",
    "number": "1144235235",
    "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": "217-709-2386",
            "fax_number": "217-709-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 SOUTHWEST FWY STE 104",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741805",
            "telephone_number": "713-270-0632",
            "fax_number": "713-270-5263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN CO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
        "enumeration_date": "2006-07-29",
        "last_updated": "2019-05-21",
        "status": "A",
        "authorized_official_last_name": "SWEETEN",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "217-709-2386"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "24591",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "466257",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470853",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4539853",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALGREENS #10522",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WALGREENS #10522",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.