Organization · Type 2 NPI

Walgreen Co

Pharmacy · Russellville, AR

NPI number 1164449591 Active

Practice location

1100 E Main St
Russellville, AR 72801-5319

Call (479) 967-1573 Map

Fax (479) 967-1594

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	AR20538 (AR)
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…

7 other providers at this address

Other pharmacy providers in Russellville

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NPI record

NPI: 1164449591
Entity type: Organization (Type 2)
Issued: Jul 15, 2006
Last updated: Oct 12, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

<unavail>
Walgreens #10199 · doing business as
Walgreens #10199 · doing business as

Authorized official

Kira L Taylor
Manager
(217) 709-2351

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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 1164449591

Walgreen Co's National Provider Identifier is 1164449591, issued on Jul 15, 2006. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Russellville, AR. The record was last updated on Oct 12, 2026.