Organization · Type 2 NPI

Walgreen Co

Pharmacy · Staten Island, NY

NPI number 1104236355 Active

Practice location

7001 Amboy Rd
Staten Island, NY 10307-1444

Call (718) 569-5672 Map

Fax (718) 569-5673

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	032858 (NY)
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…

8 other providers at this address

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NPI record

NPI: 1104236355
Entity type: Organization (Type 2)
Issued: Apr 28, 2014
Last updated: Jun 16, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

<unavail>
Walgreens #13750 · doing business as
Walgreens #13750 · doing business as

Authorized official

Virginia Garza
Manager
(217) 709-2364

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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 1104236355

Walgreen Co's National Provider Identifier is 1104236355, issued on Apr 28, 2014. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Staten Island, NY. The record was last updated on Jun 16, 2026.