Walgreens

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

2013026259 Issued in MO

Legal business name

WALGREENS

Practice address

4218 Lindell Blvd
Saint Louis, MO 63108-2916

Phone

(314) 371-4286

NPI assigned

Jun 8, 2014

Organization subpart

No

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

Authorized official

Name

Kellye Holtgrave, PHARM.D.

Title

Supervisor

Phone

(314) 739-4503

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1402185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402185600000",
    "number": "1639582604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 THIEBES RD",
            "city": "LABADIE",
            "state": "MO",
            "postal_code": "630551710",
            "telephone_number": "636-751-5778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4218 LINDELL BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082916",
            "telephone_number": "314-371-4286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-08",
        "last_updated": "2014-06-08",
        "status": "A",
        "authorized_official_last_name": "HOLTGRAVE",
        "authorized_official_first_name": "KELLYE",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "314-739-4503",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "MO",
            "license": "2013026259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Amit Walia, MD
• Jessica Yang Walia, MD
• Hussein Ebro Waliye, M.D.
• Walk by Faith Home Care
• Walk N Faith Inc

• Community Health Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Community Health Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2014; 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.