NPIMap

Organization Active NPI

Walgreens

  • Pharmacy
  • Saugus, MA
National Provider Identifier
1700168317
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PH20621 Issued in MA
Legal business name
WALGREENS
Practice address
166 Walnut St
Saugus, MA 01906-1994
Phone
(781) 941-2690
NPI assigned
Sep 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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

Authorized official

Name
Mr. Brent Robert Barke, RPH
Title
Pharmacist
Phone
(781) 941-2690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PH20621 MA Primary

Addresses

Primary practice location

166 Walnut St
Saugus, MA 01906-1994

Mailing address

44 Cannon Rock Rd
Lynn, MA 01904-1563
Phone (978) 857-3253

Other identifiers 1

IdentifierTypeStateIssuer
04158801MedicaidMA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315526400000",
    "number": "1700168317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 CANNON ROCK RD",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019041563",
            "telephone_number": "978-857-3253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 WALNUT ST",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019061994",
            "telephone_number": "781-941-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-09",
        "last_updated": "2011-09-09",
        "status": "A",
        "authorized_official_last_name": "BARKE",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "781-941-2690",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MA",
            "license": "PH20621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04158801",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saugus, MA

Sources for this page

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