Organization · Type 2 NPI

Walgreen Co

Pharmacy · Santa Fe, NM

NPI number 1104120047 Active

Practice location

5721 Airport Rd
Santa Fe, NM 87507

Call (505) 216-1492 Map

Fax (505) 216-1498

Mailing address

1901 E Voorhees St, Ms 790
Danville, IL 61834-4509

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy Primary	333600000X	PH00004113 (NM)
Community/Retail Pharmacy	3336C0003X	None listed

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 lo…

Another provider at this address

Zivile Seamons, PharmDPharmacist Santa Fe, NM NPI 1700285798

Other pharmacy providers in Santa Fe

See all in Santa Fe →

NPI record

NPI: 1104120047
Entity type: Organization (Type 2)
Issued: Jan 7, 2011
Last updated: Sep 9, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

<unavail>
Walgreens #12005 · doing business as
Walgreens #12005 · doing business as

Authorized official

Virginia Garza
Manager
(217) 709-2364

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104120047

Walgreen Co's National Provider Identifier is 1104120047, issued on Jan 7, 2011. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Santa Fe, NM. The record was last updated on Sep 9, 2026.