Organization · Type 2 NPI

Walgreen Co

Pharmacy · Jackson, MS

NPI number 1104831361 Active

Practice location

3445 Terry Rd
Jackson, MS 39212-4956

Call (601) 372-8750 Map

Mailing address

1901 E Voorhees St, M/s 790
Danville, IL 61834-4509

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy Primary	333600000X	0410401WJ (MS)
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…

2 other providers at this address

Other pharmacy providers in Jackson

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NPI record

NPI: 1104831361
Entity type: Organization (Type 2)
Issued: Jul 29, 2006
Last updated: Feb 11, 2019
Status: Active
Subpart: Yes of Walgreens Boots Alliance Inc.

Other names

<unavail>
Walgreens #04191 · former legal business name
Walgreens #04191 · former legal business name

Authorized official

Alyssa Sweeten
Manager
(217) 709-2386

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 1104831361

Walgreen Co's National Provider Identifier is 1104831361, issued on Jul 29, 2006. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Jackson, MS. The record was last updated on Feb 11, 2019.