Organization Active NPI

Walgreen Co

Doing business as Walgreens #12679

  • Pharmacy
  • Anchorage, AK
National Provider Identifier
1427284223
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
463 Issued in AK
Legal business name
WALGREEN CO
Doing business as
Walgreens #12679
Practice address
7600 Debarr Rd.
Anchorage, AK 99504-1800
Phone
(907) 771-9920
Fax
(907) 771-9885
NPI assigned
Jun 8, 2009
Last updated
May 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WALGREENS BOOTS ALLIANCE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 29, 2024

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)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 463 AK Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

7600 Debarr Rd.
Anchorage, AK 99504-1800

Mailing address

1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 709-2351

Other identifiers 3

IdentifierTypeStateIssuer
1028397MedicaidAK
0227985OtherAKNCPDP
MS0012 DMEMedicaidAK

Other names 1

  • Walgreens #12679 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070917000779 TX Part B Supplier - Centralized Flu Biller 0941278253 This NPI is an additional NPI on the enrollment
O20210518003132 AK Part B Supplier - Independent Clinical Laboratory 0941278253 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anchorage, AK; Soldotna, AK; Fairbanks, AK; Eagle River, AK

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Walgreens Holding Company

Member of 16

Organizations this organization is a member of, according to the National Provider Directory.

View all 16

Locations

7600 Debarr Rd
Anchorage, AK 99504
Phone (907) 771-9920

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1427284223",
    "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": "7600 DEBARR RD.",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995041800",
            "telephone_number": "907-771-9920",
            "fax_number": "907-771-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN CO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
        "enumeration_date": "2009-06-08",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "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": "AK",
            "license": "463",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028397",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0227985",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MS0012 DME",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walgreens #12679",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walgreens #12679",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.