Active NPI
Walgreen Co
Doing business as Walgreens #21391
- Pharmacy
- Canonsburg, PA
National Provider Identifier
1275205197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- WALGREEN CO
- Doing business as
- Walgreens #21391
- Practice address
- 1000 Mylan Blvd
Canonsburg, PA 15317-5853 - Phone
- (412) 788-0438
- Fax
- (217) 709-2344
- NPI assigned
- Sep 29, 2021
- Last updated
- Jun 15, 2022
- Organization subpart
- Yes
- Parent organization
- WALGREENS BOOTS ALLIANCE INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kira Taylor
- Title
- Manager
- Phone
- (217) 709-2351
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
1000 Mylan Blvd
Canonsburg, PA 15317-5853
Mailing address
1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 709-2351
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6010704 | Other | PA | NCPDP |
Other names 1
- Walgreens #21391
National Provider Directory
National Provider Directory- Tax ID family
- Walgreen Co
- Part of
- Walgreens Holding Company
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Locations
1000 Mylan Blvd
Canonsburg, PA 15317
Phone (304) 554-5298
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632873600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1655251200000",
"number": "1275205197",
"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": "1000 MYLAN BLVD",
"city": "CANONSBURG",
"state": "PA",
"postal_code": "153175853",
"telephone_number": "412-788-0438",
"fax_number": "217-709-2344"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALGREEN CO",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
"enumeration_date": "2021-09-29",
"last_updated": "2022-06-15",
"certification_date": "2022-06-15",
"status": "A",
"authorized_official_last_name": "TAYLOR",
"authorized_official_first_name": "KIRA",
"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": null,
"license": null,
"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": "6010704",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Walgreens #21391",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Walgreens #21391",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Canonsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.