NPIMap

Organization Active NPI

Walgreen Co./Ill.

  • Community/Retail Pharmacy
  • Salt Lake City, UT
National Provider Identifier
1194002774
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
9691412-1701 Issued in UT
Legal business name
WALGREEN CO./ILL.
Practice address
4040 W 5415 S
Salt Lake City, UT 84118-4308
Phone
(801) 982-1912
NPI assigned
Nov 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Authorized official

Name
Dr. Chad Jolley, PHARM D
Title
Pharmacist
Phone
(801) 982-1912

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 9691412-1701 UT Primary

Addresses

Primary practice location

4040 W 5415 S
Salt Lake City, UT 84118-4308

Mailing address

200 Wilmot Rd
Deerfield, IL 60015-4620
Phone (801) 982-1912

National Provider Directory

National Provider Directory
Tax ID family
Walgreen Co8,684 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320796800000",
    "number": "1194002774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WILMOT RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154620",
            "telephone_number": "801-982-1912",
            "fax_number": "801-982-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 W 5415 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841184308",
            "telephone_number": "801-982-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN CO./ILL.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A",
        "authorized_official_last_name": "JOLLEY",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "801-982-1912",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "9691412-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.