Active NPI
Walgreen Co.
Doing business as Coushatta Family Pharmacy
- Pharmacy
- Kinder, LA
National Provider Identifier
1861725913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 6189
- Legal business name
- WALGREEN CO.
- Doing business as
- Coushatta Family Pharmacy
- Practice address
- 287 Panther Trail
Kinder, LA 70648 - Phone
- (337) 738-3095
- NPI assigned
- Sep 8, 2009
- Last updated
- Oct 27, 2009
- Organization subpart
- Yes
- Parent organization
- WALGREEN CO.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Kermit R Crawford
- Title
- Senior Vice President
- Phone
- (847) 914-3154
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | 6189 | LA | Primary |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
287 Panther Trail
Kinder, LA 70648
Mailing address
1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 554-8786
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1934721 | Other | NCPDP |
Other names 1
- Coushatta Family Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Walgreen Co
- Part of
- Walgreens 01007
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": "1252368000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1256601600000",
"number": "1861725913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 E VOORHEES ST",
"address_2": "MS 790",
"city": "DANVILLE",
"state": "IL",
"postal_code": "618344509",
"telephone_number": "217-554-8786",
"fax_number": "217-554-8546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "287 PANTHER TRAIL",
"city": "KINDER",
"state": "LA",
"postal_code": "70648",
"telephone_number": "337-738-3095"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALGREEN CO.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WALGREEN CO.",
"enumeration_date": "2009-09-08",
"last_updated": "2009-10-27",
"status": "A",
"authorized_official_last_name": "CRAWFORD",
"authorized_official_first_name": "KERMIT",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
"authorized_official_telephone_number": "847-914-3154",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "LA",
"license": "6189",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "1934721",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Coushatta Family Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kinder, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.