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Export Provider Record NPI 1104831130
Walgreen Co
Organization Subpart: YES
Active
NPI Number1104831130
NPI TypeNPI-2 Organization
SpecialtyPharmacy
Provider Details
NPI1104831130
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-07-29
Last Updated2023-02-27
Authorized OfficialKira Taylor
Manager
Phone: 2177092351
Mailing Address1901 E Voorhees St, Ms 790
Danville, IL 61834-4509
United States
Phone: (217) 709-2351 | Fax: (217) 709-2344
📍 View Map
Primary Practice Address4161 S Staples St
Corpus Christi, TX 78411-2155
United States
Phone: (361) 814-5806 | Fax: (361) 814-4189
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)4597223Other ID Number-Commercial Number
MEDICAIDTX463911
MEDICAIDTX468938
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes333600000X – PharmacyTX17138
No291U00000X – Clinical Medical Laboratory
No332B00000X – Durable Medical Equipment & Medical Supplies
No3336C0003X – Pharmacy, Community/Retail Pharmacy
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About NPI 1104831130

Walgreen Co is an organization registered in the CMS NPPES NPI Registry with NPI number 1104831130. The primary specialty listed is Pharmacy. The organization is located in Corpus Christi, TX. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-07-29. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1104831130?

NPI 1104831130 belongs to Walgreen Co, a Pharmacy in Corpus Christi, TX. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1104831130 active?

The current status of NPI 1104831130 in the NPPES registry is Active. The record was last updated on 2023-02-27.

What specialty is NPI 1104831130?

NPI 1104831130 is classified under the taxonomy Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1104831130?

You can verify NPI 1104831130 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1104831130?

The primary practice address on file for NPI 1104831130 is 4161 S Staples St, Corpus Christi, TX 78411-2155. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1104831130 issued?

NPI 1104831130 was first issued (enumerated) on 2006-07-29. The NPPES record was last updated on 2023-02-27.

Practice Location Map

Walgreen Co is located at 4161 S Staples St, Corpus Christi, TX. Use the map below to find directions or verify the practice location.

📍 4161 S Staples St, Corpus Christi, TX 78411-2155  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Walgreen Co. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1104831130. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy17138TX
Data Verified from CMS NPPES Last synced: 2026-06-26 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162