Walgreen Co
Organization Active NPI Mail Order Pharmacy · Northlake, TX
NPI 1366028995 · NPPES record last updated Oct 5, 2023
Key facts
- NPI
- 1366028995
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mail Order Pharmacy 3336M0002X
- Legal business name
- WALGREEN CO
- Practice address
- 4100 Dale Earnhardt Way Ste 200
Northlake, TX 76262-2389 - Phone
- (817) 859-1400
- NPI assigned
- Mar 23, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- WALGREENS BOOTS ALLIANCE INC
Authorized official
- Name
- Kira Taylor
- Title
- Manager
- Phone
- (217) 709-2351
Corporate family (same tax ID) 24
Practitioners 4
-
Tarenaya Sontay Smith, PHARMD
National Provider Directory
- Tax ID family
- Walgreen Co
- Part of
- Walgreens Holding Company
Locations
4100 Dale Earnhardt Way
Northlake, TX 76262
4100 Dale Earnhardt Way
Ste 200
Northlake, TX 76262
Phone (817) 859-1400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Mail Order Pharmacy | 3336M0002X | Yes |
Addresses
Primary practice location
4100 Dale Earnhardt Way Ste 200
Northlake, TX 76262-2389
Mailing address
1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 709-2351
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5933684 | Other | TX | NCPDP |
Other names
- Walgreens #21373
Other providers in Northlake, TX
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- Jacey M Vu
- Justin Watts
- Cody Glenn White
- Kaley Leann Wymack
- Keaton Elliot Yowell
All providers in Northlake, TX · Mail Order Pharmacy in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.