NPIMap

Organization Active NPI

Walgreens

  • Pharmacy
  • Kendallville, IN
National Provider Identifier
1699057596
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
26021102A Issued in IN
Legal business name
WALGREENS
Practice address
124 E North St
Kendallville, IN 46755-1124
Phone
(260) 349-1530
Fax
(260) 349-1936
NPI assigned
Sep 15, 2011
Last updated
Sep 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Authorized official

Name
Michael S Jones, PHARM.D.
Title
Pharmacist
Phone
(260) 338-1016

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 26021102A IN Primary

Addresses

Primary practice location

124 E North St
Kendallville, IN 46755-1124

Mailing address

11728 Coral Springs Dr
Fort Wayne, IN 46845-9594
Phone (260) 338-1016

National Provider Directory

National Provider Directory
Tax ID family
Costco Pharmacy44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

124 E North St
Kendallville, IN 46755
Phone (260) 349-1530

NPI Registry JSON

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1699057596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11728 CORAL SPRINGS DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459594",
            "telephone_number": "260-338-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E NORTH ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467551124",
            "telephone_number": "260-349-1530",
            "fax_number": "260-349-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "260-338-1016",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IN",
            "license": "26021102A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kendallville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.