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Walgreen Co — NPI 1093996399, Idaho Falls, ID | NPI Central

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NPI 1093996399

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Walgreen Co

NPI 1093996399 · Pharmacy · Idaho Falls, ID

Provider details

NPI number: 1093996399
Entity type: Organization
Primary specialty: PharmacySuppliers
Parent organization: Walgreens Boots Alliance Inc
Organization subpart: Yes
Authorized official: Kira Taylor, Manager(217) 709-2351

Specialties & taxonomies

PharmacyPrimary333600000XLicense 37895RP (ID)
Suppliers
Durable Medical Equipment & Medical Supplies332B00000X
Suppliers
Community/Retail Pharmacy3336C0003X
Suppliers

Practice location

1604 W Broadway St

Idaho Falls, ID 83402-3048

Phone: (208) 522-4655

Fax: (208) 522-6670

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

1901 E Voorhees St

Danville, IL 61834-4509

Other names (DBA / former)

Doing business as: Walgreens #15973
Doing business as: Walgreens #15973

Registry dates

Enumerated: 2007-11-15
Last updated: 2022-05-04
Certified: 2022-05-04

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.