Walgreen Co
Pharmacy in Chantilly, VA. Organization (NPI-2).
NPI number1457679151
StatusActive
Last updated in NPPESApr 1, 2022
Details
- NPI
- 1457679151
- Entity type
- Organization (NPI-2)
- Legal business name
- Walgreen Co
- Organization subpart
- Yes
- Enumeration date
- May 6, 2010
- Certification date
- Apr 1, 2022
- Last updated
- Apr 1, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | 0201004345 | VA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Walgreens #12361 (Doing Business As)
Practice location
25421 Eastern Marketplace PlzChantilly, VA 20152-5780
Phone 703-327-7817 · Fax 703-327-2618
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
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