Organization · Type 2 NPI

Walgreen Co

Pharmacy · Blackfoot, ID

NPI number 1306086053 Active

Practice location

960 W Bridge St
Blackfoot, ID 83221-1912

Call (208) 785-8000 Map

Fax (208) 785-9624

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	38492RP (ID)
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…

5 other providers at this address

Other pharmacy providers in Blackfoot

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NPI record

NPI: 1306086053
Entity type: Organization (Type 2)
Issued: Feb 20, 2009
Last updated: Aug 31, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

<unavail>
Walgreens #13672 · doing business as
Walgreens #13672 · doing business as

Authorized official

Kira 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 1306086053

Walgreen Co's National Provider Identifier is 1306086053, issued on Feb 20, 2009. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Blackfoot, ID. The record was last updated on Aug 31, 2026.