Active NPI
Walgreens
- Community/Retail Pharmacy
- Victorville, CA
National Provider Identifier
1720360852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 63864
- Legal business name
- WALGREENS
- Practice address
- 13655 Bear Valley Rd
Victorville, CA 92392-8521 - Phone
- (760) 949-8930
- NPI assigned
- Sep 14, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Charles Kistner
- Title
- Pharmacist
- Phone
- (760) 949-8930
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 63864 | CA | Primary |
Addresses
Primary practice location
13655 Bear Valley Rd
Victorville, CA 92392-8521
Mailing address
13655 Bear Valley Rd
Victorville, CA 92392-8521
National Provider Directory
National Provider Directory- Tax ID family
- Walgreen Co
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.
Locations
13655 Bear Valley Rd
Victorville, CA 92392
Phone (760) 949-0848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315958400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1315958400000",
"number": "1720360852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13655 BEAR VALLEY RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923928521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13655 BEAR VALLEY RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923928521",
"telephone_number": "760-949-8930"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALGREENS",
"organizational_subpart": "NO",
"enumeration_date": "2011-09-14",
"last_updated": "2011-09-14",
"status": "A",
"authorized_official_last_name": "KISTNER",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "CHARLES",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "760-949-8930"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "63864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
- Wal-Mart Stores, Inc (Wal-Mart Vision Center 30-4392)
- Wal-Mart Stores, Inc. (Vision Center 30-1588)
- Walgreen Co (Walgreens #12862)
- Walgreen Co (Walgreens #09254)
- Walgreen Co (Walgreens #12576)
- Demetrius Richard Wallace
- Trina Denise Wallace
- Marlene Libby Wallis, RPH
- Walmart Inc. (Walmart Pharmacy 10-1588)
- Walmart Inc. (Walmart Pharmacy 10-4392)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.