Active NPI
Walgreen Co.
Doing business as Walgreens #17205
- Pharmacy
- Baltimore, MD
National Provider Identifier
1710733514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- WALGREEN CO.
- Doing business as
- Walgreens #17205
- Practice address
- 1030 W 41St St Ste E
Baltimore, MD 21211-1662 - Phone
- (410) 235-0002
- NPI assigned
- Apr 24, 2024
- Organization subpart
- Yes
- Parent organization
- WALGREENS BOOTS ALLIANCE INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Virginia Garza
- Title
- Director - Ar Central
- Phone
- (217) 709-2364
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
1030 W 41St St Ste E
Baltimore, MD 21211-1662
Mailing address
1901 E Voorhees St # Ms 790
Danville, IL 61834-4509
Phone (217) 709-2364
Other names 1
- Walgreens #17205
National Provider Directory
National Provider Directory- Tax ID family
- Walgreen Co
- Part of
- Walgreens Holding Company
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713916800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1713916800000",
"number": "1710733514",
"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": "217-709-2364",
"fax_number": "217-709-2344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 W 41ST ST STE E",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212111662",
"telephone_number": "410-235-0002"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALGREEN CO.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
"enumeration_date": "2024-04-24",
"last_updated": "2024-04-24",
"certification_date": "2024-04-24",
"status": "A",
"authorized_official_last_name": "GARZA",
"authorized_official_first_name": "VIRGINIA",
"authorized_official_title_or_position": "DIRECTOR - AR CENTRAL",
"authorized_official_telephone_number": "217-709-2364"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Walgreens #17205",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Baltimore, MD
- Walgreen Co. (Walgreens #19115)
- Walgreen Co. (Walgreens #21331)
- Walgreen Co. (Walgreens #5409)
- Walgreen Co. (Walgreens #16190)
- Walgreen Co. (Walgreens #6779)
- Walgreen Co. (Walgreens #17609)
- Walgreen Co. (Walgreens #7573)
- Walgreen Co. (Walgreens #6320)
- Walgreen Co. (Walgreens #16191)
- Walgreen Co. (Walgreens #19149)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.