Walgreen Co
Pharmacy in Peoria, IL. Organization (NPI-2).
NPI number1518972736
StatusActive
Last updated in NPPESMay 10, 2022
Details
- NPI
- 1518972736
- Entity type
- Organization (NPI-2)
- Legal business name
- Walgreen Co
- Organization subpart
- Yes
- Enumeration date
- Jul 29, 2006
- Certification date
- May 10, 2022
- Last updated
- May 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | 054.019256 | IL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Walgreens #06604 (Doing Business As)
Practice location
1919 W Pioneer PkwyPeoria, IL 61615-1825
Phone 309-692-0039
Mailing address
1901 E Voorhees StMailstop #790
Danville, IL 61834-4509
Phone 217-709-2351 · Fax 217-709-2344
Authorized official
Kira L Taylor
Manager
2177092351
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