Active NPI
Walgreen Co.
Doing business as Walgreens #17409
- Clinical Medical Laboratory
- Hurricane, WV
National Provider Identifier
1821717315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- WALGREEN CO.
- Doing business as
- Walgreens #17409
- Practice address
- 215 State Route 34
Hurricane, WV 25526-7003 - Phone
- (304) 757-7318
- NPI assigned
- Aug 26, 2022
- Last updated
- Aug 26, 2022
- 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
- Kira L Taylor
- Title
- Manager
- Phone
- (217) 709-2351
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | NU | Primary |
Addresses
Primary practice location
215 State Route 34
Hurricane, WV 25526-7003
Mailing address
1901 E Voorhees St # Ms 790
Danville, IL 61834-4509
Phone (217) 709-2351
Other names 1
- Walgreens #17409
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D2234091 | Walgreens #17409 | Certificate of waiver | Aug 26, 2027 |
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.
Locations
215 State Route 34
Hurricane, WV 25526
Phone (304) 757-7318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661472000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1661472000000",
"number": "1821717315",
"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": "217-709-2351",
"fax_number": "217-709-2344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 STATE ROUTE 34",
"city": "HURRICANE",
"state": "WV",
"postal_code": "255267003",
"telephone_number": "304-757-7318"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALGREEN CO.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
"enumeration_date": "2022-08-26",
"last_updated": "2022-08-26",
"certification_date": "2022-08-22",
"status": "A",
"authorized_official_last_name": "TAYLOR",
"authorized_official_first_name": "KIRA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "217-709-2351"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Walgreens #17409",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Hurricane, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.