NPIMap

Organization Active NPI

Walgreens

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1164830790
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S020688 Issued in AZ
Legal business name
WALGREENS
Practice address
1919 N Dobson
Phoenix, AZ 85524
Phone
(480) 899-6713
Fax
(480) 899-3415
NPI assigned
Jul 28, 2014
Last updated
Jul 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2014

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

Authorized official

Name
Dr. Bradley Scott Bidese, PHARM.D.NPI 1548679228
Title
Pharmacist
Phone
(708) 912-0348

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S020688 AZ Primary

Addresses

Primary practice location

1919 N Dobson
Phoenix, AZ 85524

Mailing address

14409 S 49TH St
Phoenix, AZ 85044
Phone (708) 912-0348

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406505600000",
    "number": "1164830790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14409 S 49TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85044",
            "telephone_number": "708-912-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 N DOBSON",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85524",
            "telephone_number": "480-899-6713",
            "fax_number": "480-899-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-07-28",
        "status": "A",
        "authorized_official_last_name": "BIDESE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "708-912-0348",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S020688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.