Provider Information for 1265447163
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WALGREEN CO
Other Names:Doing Business As:WALGREENS #11960Organization Subpart: YES
NPI: 1265447163
Last Updated: 2023-11-07
Certification Date: 2023-11-07
Certification Date: 2023-11-07
Details
| Name | Value | ||||||||||||||||
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| NPI | 1265447163 | ||||||||||||||||
| Enumeration Date | 2006-07-29 | ||||||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Authorized Official Information | Name: KIRA TAYLOR Title: Manager Phone: 2177092351 | ||||||||||||||||
| Mailing Address | 1901 E VOORHEES ST MS 790 DANVILLE, IL 61834-4509 United States Phone: 217-709-2351 | Fax:217-709-2344 | ||||||||||||||||
| Primary Practice Address | 1256 EL PASEO RD LAS CRUCES, NM 88001-6026 United States Phone: 575-525-8713 | Fax:575-541-8561 | ||||||||||||||||
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