Walgreen's

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RP00008469 Issued in NM

Legal business name

WALGREEN'S

Practice address

4051 Southern Blvd SE
Rio Rancho, NM 87124-2069

Phone

(505) 892-6690

NPI assigned

Nov 19, 2015

Last updated

Nov 19, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Konkol, PHARM D.

Title

Pharmacist

Phone

(510) 427-1673

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447891200000",
    "number": "1366816845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4051 SOUTHERN BLVD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871242069",
            "telephone_number": "505-892-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 SOUTHERN BLVD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871242069",
            "telephone_number": "505-892-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN'S",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-19",
        "last_updated": "2015-11-19",
        "status": "A",
        "authorized_official_last_name": "KONKOL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "510-427-1673",
        "authorized_official_credential": "PHARM D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NM",
            "license": "RP00008469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #05732)
• Walgreen Co (Walgreens #12270)
• Walgreen Co (Walgreens #04187)
• Walgreen Co (Walgreens #05158)
• Walgreen Co (Walgreens #16390)
• Walk the Walk Counseling LLC
• Adrianna Walker
• Lee Ellen Walker, MA
• William Lee Walker, D.C.
• Shawn Michael Wallace, PA-C

• Community/Retail Pharmacy in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• Community/Retail Pharmacy in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.