WALGREEN CO. NPI 1003002254

Pharmacy in Gray, TN

About WALGREEN CO.

Walgreen Co. is a provider in Gray, TN. The NPI number assigned to this provider is 1003002254. The practitioner's primary taxonomy code is Pharmacy (333600000X). The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Walgreens #11113.

NPI

1003002254

Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameWALGREEN CO.
Provider Location Address5104 BOBBY HICKS HWY GRAY, TN 37615 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address1901 E VOORHEES ST MAILSTOP #790 DANVILLE, IL 61834 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?Yes Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization NameWALGREENS #11113 Additional informationCallout TooltipProvider other organization name
The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Other Name TypeDoing Business As (3)
Enumeration Date09-21-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date07-25-2016 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

WALGREEN CO.
5104 BOBBY HICKS HWY
GRAY, TN
ZIP 37615
Phone: (423) 477-3372
Get Directions

Mailing Address

WALGREEN CO.
1901 E VOORHEES ST
MAILSTOP #790
DANVILLE, IL
ZIP 61834
Phone: (217) 709-2386
Fax: (217) 709-2344

Primary Taxonomy

Taxonomy Code333600000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationPharmacy
TypeSuppliers
License No.4444
License StateTN
Taxonomy DescriptionA 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.

Authorized Official

Authorized Official NameMR. ALAN T NIELSEN Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitleTREASURER
Authorized Official Phone(847) 315-3523

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1332B00000XSuppliersDurable Medical Equipment & Medical SuppliesNo

Taxonomy Description: a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time.

23336C0003XSuppliersPharmacyCommunity/Retail PharmacyNo

Taxonomy Description: a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
4440664OTHER (01)
P00400633MEDICARE PIN (08)
4440664MEDICAID (05)TN
0282936022MEDICARE NSC (07)
PHC049MEDICARE PIN (08)

Map Location


WALGREEN CO. address is 5104 BOBBY HICKS HWY GRAY, TN 37615

Other Providers at the same location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1255642005 LAURA C DINISIO PHARMD
Individual
Pharmacist5104 BOBBY HICKS HWY
GRAY, TN 37615
(423) 477-8533
1265743405DR. WILLIAM CORTNEY YATES PHARM.D.
Individual
Pharmacist5104 BOBBY HICKS HWY
GRAY, TN 37615
(423) 477-3372
1497066609 MANDY DISHNER PHARM.D.
Individual
Pharmacist5104 BOBBY HICKS HWY
GRAY, TN 37615
(423) 477-3372
1518307917 ARISSA BROOKE VAUGHN PHARMD
Individual
Pharmacist5104 BOBBY HICKS HWY
GRAY, TN 37615
(423) 477-3372
1528379252 BILLIE REILLY PHARM.D.
Individual
Pharmacist5104 BOBBY HICKS HWY
GRAY, TN 37615
(423) 477-3372
1770923443 ABIGAIL BROWN PHARMD
Individual
Pharmacist5104 BOBBY HICKS HWY
GRAY, TN 37615
(423) 477-3372
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