Walgreen Co., NPI 1396786265
Pharmacy in Kirksville, MO, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1396786265
NPI Entity Type Organization
Provider Name Walgreen Co.
Doing Business As
Subpart of Organization Walgreens Boots Alliance Inc
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 311 N Baltimore St, Kirksville, MO, US
Provider Mailing Address 1901 E Voorhees St, Ms 790, Danville, IL, US, 618344509
Gender Male
Is Sole Proprietor? No
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Organization Official

Official Name Lisa Badgley
Official Position SENIOR VICE PRESIDENT
Phone 847-315-3012

Primary Taxonomy

Taxonomy Code

333600000X

Taxonomy Name Pharmacy
Classification

Pharmacy

Group

Suppliers

License No. 26006015825
License State MO
Description 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.

Other Organization Name

Walgreens #09986
Doing Business As

Business Address

Walgreen Co.
311 N Baltimore St

Kirksville, MO, US

Phone: 660-665-3063
Fax: 660-665-8456

Mailing Address

Walgreen Co.
1901 E Voorhees St
Ms 790
Danville, IL, US
ZIP 618344509
Phone: 217-709-2351
Fax: 217-709-2344

Secondary Taxonomies

Taxonomy Code Group Classification License No. State Primary?

332B00000X

Suppliers

Durable Medical Equipment & Medical Supplies

No

3336C0003X

Suppliers

Pharmacy

No

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
606256709 MO MEDICAID 05
2636516 NCPDP 01
0722553 IA MEDICAID 05

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NPI Name Taxonomy Address

1679982664

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DR. MD Douglas James Cassidy

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FNP-C Kyle Douglas Gronberg

Individual

Nurse Practitioner

3801 S National Ave Ste 900

Springfield, MO

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