Active NPI
Walgreen Co
- Pharmacy
- Columbus, OH
National Provider Identifier
1881601896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 21412850
- Legal business name
- WALGREEN CO
- Practice address
- 410 W 10TH Ave
Columbus, OH 43210-1240 - Phone
- (614) 293-3313
- Fax
- (614) 294-3926
- NPI assigned
- Aug 2, 2006
- 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
- Mr. Alan T Nielsen
- Title
- Treasurer
- Phone
- (847) 315-3523
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 21412850 | OH | Primary |
| Clinic Pharmacy | 3336C0002X | |||
| Community/Retail Pharmacy | 3336C0003X | |||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
410 W 10TH Ave
Columbus, OH 43210-1240
Mailing address
1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 709-2386
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2452546 | Medicaid | OH | |
| 1881601896 | Medicaid | KY | |
| 07516640003 | Medicaid | PA | |
| 200337330A | Medicaid | IN | |
| 3671989 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 9001141200 | Medicaid | KY |
Other names 1
- WALGREENS #02127
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070917000779 | TX | Part B Supplier - Centralized Flu Biller | 0941278253 | This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- Walgreens Holding Company
Member of 16
Organizations this organization is a member of, according to the National Provider Directory.
-
- Home Infusion Therapy Pharmacy
- Sauk Rapids, MN
- NPI 1891746111
Member Of
-
- Home Infusion Therapy Pharmacy
- Nashville, TN
- NPI 1326279746
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1548115200000",
"number": "1881601896",
"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": "217-709-2386",
"fax_number": "217-709-2344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 W 10TH AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432101240",
"telephone_number": "614-293-3313",
"fax_number": "614-294-3926"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALGREEN CO",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
"enumeration_date": "2006-08-02",
"last_updated": "2019-01-22",
"status": "A",
"authorized_official_last_name": "NIELSEN",
"authorized_official_first_name": "ALAN",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "TREASURER",
"authorized_official_telephone_number": "847-315-3523",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "OH",
"license": "21412850",
"primary": true
},
{
"code": "3336C0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Clinic Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2452546",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1881601896",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07516640003",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200337330A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3671989",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9001141200",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "WALGREENS #02127",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "WALGREENS #02127",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.