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WALGREENS #12604
NPI 1710143169
Pharmacy in Atlanta, GA

Active since August 05, 2008
340 BOULEVARD NE STE 143, ATLANTA, GA 30312(404) 525-8256 Get Directions Write a Review

NPPES record last updated: January 13, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Walgreens #12604 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALGREENS #12604 (NPI 1710143169) is a healthcare organization registered as a pharmacy in Atlanta, Georgia and active in the NPI registry since August 2008. The organization lists Alan T Nielsen, Treasurer, as its authorized official.

NPPES Registry Identity

NPI1710143169
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address340 BOULEVARD NE STE 143Atlanta, GA 30312-1278
Mailing Address1901 E Voorhees St, Ms #790Danville, IL 61834-4509 · (217) 709-2386 · Fax (217) 709-2344
Phone(404) 525-8256
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialAlan T NielsenTreasurer · (847) 315-3523
Enumeration DateAugust 5, 2008
Last NPPES UpdateJanuary 13, 2016
✔ NPI 1710143169 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in GA · PHRE009535
Definition
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
340 BOULEVARD NE STE 143, Atlanta, GA 30312
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Other Names 1

Doing Business AsWalgreens #12604

Other Identifiers 6

Medicare NSC0282936632
Other1157684Ncpdp
Other842024867BGA · Medicaid Dme
Medicare PINPHC049
Medicaid842024867AGA
Medicare PINP00400633

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MANEY MAZLOOM PHARMD
Pharmacist
340 BOULEVARD NE STE 143
ATLANTA, GA 30312
Fulton County (404) 525-8256
NANCY JO ROSS PHARMD, BCACP
Pharmacist
340 BOULEVARD NE STE 143
ATLANTA, GA 30312
Fulton County (404) 929-1013

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1710143169. It was assigned to this organization in the NPPES registry on August 5, 2008. The provider is doing business as Walgreens #12604.

Where is Walgreen Co located?

Walgreen Co is located at 340 Boulevard NE Ste 143, Atlanta, GA 30312. The listed phone number is (404) 525-8256.

What is Walgreen Co's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

When was this NPI record last updated?

The NPPES record for Walgreen Co was last updated on January 13, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.