Walgreen Co.
Clinical Medical Laboratory in Ravenswood, WV. Organization (NPI-2).
NPI number1124746565
StatusActive
Last updated in NPPESAug 22, 2022
Details
- NPI
- 1124746565
- Entity type
- Organization (NPI-2)
- Legal business name
- Walgreen Co.
- Organization subpart
- Yes
- Enumeration date
- Aug 22, 2022
- Certification date
- Aug 22, 2022
- Last updated
- Aug 22, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- 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 |
|---|---|---|---|---|
| 291U00000X | Clinical Medical Laboratory | – | – | Yes |
Other names
- Walgreens # 17280 (Doing Business As)
Practice location
406 Washington StRavenswood, WV 26164-1706
Phone 304-273-4496
Mailing address
1901 E Voorhees St # Ms 790Danville, IL 61834-4509
Phone 217-709-2351 · Fax 217-709-2344
Authorized official
Kira L Taylor
Manager
2177092351
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