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WALGREEN CO NPI 1174719447


NPI Information

NPI: 1174719447
Provider Name: WALGREEN CO

Doing Business As: WALGREENS # 10165

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 49D2039987

Address:
603 ELDEN ST
HERNDON, VA
ZIP 20170
Phone: (703) 796-6482
Get Directions

WALGREEN CO is a pharmacy in Herndon, VA. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. WALGREEN CO NPI is 1174719447. The provider is registered as an organization entity type.
The provider Is Doing Business As Walgreens # 10165.

The provider's business location address is:

603 ELDEN ST
HERNDON, VA
ZIP 20170-722
Phone: (703) 796-6482
Fax: (703) 796-6488

The provider's authorized official is Kira Taylor .
The authorized official title is Manager and has the following contact phone number (217) 709-2351.

The CLIA number assigned to this NPI record is 49D2039987 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/20/2007 and was last updated on 10/30/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacy0201004201VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14840509OTHERNCPDP
21174719447MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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