Walgreens Health Services LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

WALGREENS HEALTH SERVICES LLC

Doing business as

Walgreens Health

Practice address

615 Broadway
Millbrae, CA 94030-1909

Phone

(650) 651-0558

NPI assigned

Apr 17, 2023

Organization subpart

No

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

Authorized official

Name

Sashidaran Moodley

Title

Chief Medical Officer

Phone

(312) 982-1242

Specialties & licenses 1

Addresses

Other names 1

• Walgreens Health Doing business as

Tax ID family

Walgreens Health3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Walgreens Health Services LLC

  • Clinic/Center
  • Akron, OH
  • NPI 1316670144
  NPD tax ID
• Walgreens Health Services LLC

  • Clinic/Center
  • Elizabeth, NJ
  • NPI 1326754169
  NPD tax ID

Locations

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1730875188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 WILMOT RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 BROADWAY",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940301909",
            "telephone_number": "650-651-0558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-17",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "MOODLEY",
        "authorized_official_first_name": "SASHIDARAN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "312-982-1242"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walgreens Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walgreens Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Supriya Suraj Vasanth, DMD
• Amanda Kalani Vasquez, MA, PPS
• Cammy Bele Vue, LVN
• Walgreen Co
• Walgreen Co
• Ling Wang
• Sheng Wang
• Yuanjun Wang
• Zeyu Wang
• James Warren, D.D.S.

• Clinic/Center in Millbrae, CA
• Providers in Millbrae, CA by specialty
• Clinic/Center in California

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

Verify at the official NPI Registry.