Walgreen Co
Organization Active NPI Pharmacy · Stamford, NY
NPI 1548784333 · NPPES record last updated Jun 24, 2026
Key facts
- NPI
- 1548784333
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 036230 (NY)
- Legal business name
- WALGREEN CO
- Practice address
- 5 Lake St
Stamford, NY 12167-1007 - Phone
- (607) 652-3675
- Fax
- (607) 652-6767
- NPI assigned
- Aug 2, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- WALGREENS HOLDING COMPANY
Authorized official
- Name
- Kira Taylor
- Title
- Manager
- Phone
- (217) 709-2351
Other NPIs on the same Medicare enrollment 9
Member of 16
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070917000779 | TX | Part B Supplier - Centralized Flu Biller | 0941278253 | This NPI is an additional NPI on the enrollment |
| O20221209000999 | NY | Part B Supplier - Independent Clinical Laboratory | 0941278253 |
9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Barneveld, NY; Ilion, NY; Lake George, NY; Mechanicville, NY; Queensbury, NY; Rochester, NY; Sidney, NY; Stamford, NY… |
National Provider Directory
- Part of
- Walgreens Holding Company
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 036230 | NY | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
5 Lake St
Stamford, NY 12167-1007
Mailing address
1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 709-2351
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05057516 | Medicaid | NY | |
| 5822615 | Other | NY | NCPDP |
Other names
- Walgreens #19432
Other providers in Stamford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.