WALGREENS #17031 – NPI #1912420910
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.

WALGREENS #17031 is a pharmacy located in GULFPORT, MS. NPPES has assigned the NPI number 1912420910 to WALGREENS #17031 on July 21, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “WALGREENS #17031” 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 4 years ago on May 10, 2022. 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 #17031 below.

NPI Profile for
WALGREEN CO

NPI Number
1912420910
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 #17031
Primary location
11279 HIGHWAY 49
GULFPORT, MS 39503
Phone: (228) 832-6280 Fax: (228) 832-8142
Mailing address
1901 E VOORHEES ST
MS 790
DANVILLE, IL 61834-4509
Phone: (217) 709-2351 Fax: (217) 709-2344
Organization Subpart
Yes - WALGREENS #17031 is subpart of another organization.
Authorized Official
KIRA TAYLOR
MANAGER
Phone: (217) 709-2351
Updated
Certification Date
May 10, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

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.

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.