WALGREENS #17035 – NPI #1487177481
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

Health Care Provider Taxonomy Code for Pharmacy

WALGREENS #17035 is a pharmacy located in D'IBERVILLE, MS. NPPES has assigned the NPI number 1487177481 to WALGREENS #17035 on July 21, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “WALGREENS #17035” is a dba name, the actual legal business name for this organization is WALGREEN CO. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 333600000X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy.

The NPI profile was previously updated about 8 years ago on Jun 20, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for WALGREENS #17035 below.

NPI Profile for
WALGREEN CO

NPI Number
1487177481
Enumeration Date

(about 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
WALGREEN CO
Doing Business As (dba): WALGREENS #17035
Primary location
4031 POPPS FERRY RD STE A
D'IBERVILLE, MS 39540
Phone: (217) 709-2386 Fax:
Mailing address
1901 E VOORHEES ST # MS 790
DANVILLE, IL 61834-4509
Phone: (217) 709-2386 Fax: (217) 709-2344
Organization Subpart
Yes - WALGREENS #17035 is subpart of another organization.
Authorized Official
ALYSSA SWEETEN
MANAGER
Phone: (217) 709-2386
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
333600000X
- Pharmacy (Primary)
3336C0003X
- Pharmacy / Community/Retail Pharmacy
332B00000X
- Durable Medical Equipment & Medical Supplies

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.