Walgreen Co
Pharmacy in Palm Bay, FL. Organization (NPI-2).
NPI number1477568657
StatusActive
Last updated in NPPESMay 6, 2022
Details
- NPI
- 1477568657
- Entity type
- Organization (NPI-2)
- Legal business name
- Walgreen Co
- Organization subpart
- Yes
- Enumeration date
- Jul 29, 2006
- Certification date
- May 6, 2022
- Last updated
- May 6, 2022
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 | PH018213 | FL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Walgreens #06463 (Doing Business As)
Practice location
5245 Babcock St NePalm Bay, FL 32905-4601
Phone 321-409-1148
Mailing address
1901 E Voorhees StMs 790
Danville, IL 61834-4509
Phone 217-709-2351 · Fax 217-709-2344
Authorized official
Kira L Taylor
Manager
2177092351
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 7 Pharmacy providers in Palm Bay · All 1,789 providers in Palm Bay
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