Walgreen Co

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY35432 Issued in CA

Legal business name

WALGREEN CO

Doing business as

walgreens #02126

Practice address

1414 El Camino Real
San Carlos, CA 94070-5102

Phone

(650) 637-9777

Fax

(650) 637-1012

NPI assigned

Nov 9, 2011

Organization subpart

Yes

Parent organization

WALGREEN COAs reported in NPPES

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

Authorized official

Name

Mr. Kermit R Crawford

Title

President

Phone

(847) 315-3154

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• walgreens #02126 Doing business as

Part of

Walgreens 16466

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Walgreen

  • Pharmacist
  • Citrus Heights, CA
  • NPI 1720363708
  NPPES parent name

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": "1518244193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST # MS 790",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618344509",
            "telephone_number": "217-709-2386",
            "fax_number": "217-709-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 EL CAMINO REAL",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940705102",
            "telephone_number": "650-637-9777",
            "fax_number": "650-637-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN CO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREEN CO",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "KERMIT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-315-3154",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY35432",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY35432",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA354320",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "walgreens #02126",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jenny Vosacek, MFTT
• Anh-Tu Thuy Vu, D.C.
• Teresa Wace
• Leilani Anne Wagner, DC
• Walgreen Co
• Jamica N Walker
• Jody Pamela Wallace, MS, CGC
• Wallgreens
• Amy Wang, DTCM
• Buer Wang, LAC

• Pharmacy in San Carlos, CA
• Providers in San Carlos, CA by specialty
• Pharmacy in California

• 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.