Walgreen Co
Pharmacy in Saint Louis, MO. Organization (NPI-2).
NPI number1104831346
StatusActive
Last updated in NPPESNov 9, 2023
Details
- NPI
- 1104831346
- Entity type
- Organization (NPI-2)
- Legal business name
- Walgreen Co
- Organization subpart
- Yes
- Enumeration date
- Jul 29, 2006
- Certification date
- Nov 9, 2023
- Last updated
- Nov 9, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · DME SUPPLIER - PHARMACY
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | 2834 | MO | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Walgreens #00854 (Doing Business As)
Practice location
5764 S Lindbergh BlvdSaint Louis, MO 63123-6937
Phone 314-842-3372
Mailing address
1901 E Voorhees StMs 790
Danville, IL 61834-4509
Phone 217-709-2351 · Fax 217-709-2344
Authorized official
Kira Taylor
Manager
2177092351
Is something wrong?
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