WALGREENS #19611 – NPI #1912422478
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 #19611 is a pharmacy located in ROTTERDAM, NY. NPPES has assigned the NPI number 1912422478 to WALGREENS #19611 on August 07, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “WALGREENS #19611” 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 Jun 09, 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 #19611 below.

NPI Profile for
WALGREEN CO

NPI Number
1912422478
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 #19611
Primary location
957 CURRY RD
ROTTERDAM, NY 12306-2909
Phone: (518) 356-6310 Fax: (518) 355-4015
Mailing address
1901 E VOORHEES ST
MS 790
DANVILLE, IL 61834-4509
Phone: (217) 709-2351 Fax: (217) 709-2344
Organization Subpart
Yes - WALGREENS #19611 is subpart of another organization.
Authorized Official
KIRA TAYLOR
MANAGER
Phone: (217) 709-2351
Updated
Certification Date
Jun 09, 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.

Identifiers

Identifiers for WALGREENS #19611

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERNCPDPNY5821928
MEDICAIDNY05017372
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)		 NY 036125
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.