NPI age
19 years
Enumerated 2007-02-20
● Active Type 2 · Organization
Subpart
Walgreen Co
Walgreen Co is 1 of 37 pharmacy organizations in Georgia.
Primary specialty
Pharmacy
Plus 2 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Taylor
Manager
Last NPPES update
2023-03-07
Source: monthly bulk 2026-05
How this organization compares
Across 37 active pharmacy providers in Georgia.
NPI age
19 years
↑ 3 yr above median
Practice locations
1
0 secondary on file
Subspecialties
2
In the 45% of peers with subspecialties
NPI lifetime · 2007 → 2026
2007-02Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
184 Professional Dr Unit B
Baldwin, GA 305114012
Mailing address
1901 E Voorhees St, MS #790
Danville, IL 618344509
Authorized official
Kira Taylor
Manager
📞 2177092351
Specialties
-
Pharmacy PrimaryA pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO's covered members only.
-
Durable Medical Equipment & Medical SuppliesA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
-
PharmacyA 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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 1152684 | NCPDP NO. |
| 01 (GA) | PHRE008894 | STATE LICENSE NO. |
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Fieldale Farms Family Health Care Center & Pharmacy
-
Fieldale Farms Family Health Care Center & Pharmacy
Practice context
Single-site organization. Only one practice location on file.
Subpart of Walgreen Co.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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