Provider Information for 1992710172
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WALGREEN CO
Other Names:Doing Business As:WALGREENS #06487Organization Subpart: YES
NPI: 1992710172
Last Updated: 2022-05-09
Certification Date: 2022-05-09
Certification Date: 2022-05-09
Details
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NPI | 1992710172 | ||||||||||||||||
Enumeration Date | 2006-07-29 | ||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||
Status | Active | ||||||||||||||||
Authorized Official Information | Name: KIRA L TAYLOR Title: Manager Phone: 2177092351 | ||||||||||||||||
Mailing Address | 1901 E VOORHEES ST MAILSTOP #790 DANVILLE, IL 61834-4509 United States Phone: 217-709-2351 | Fax:217-709-2344 | ||||||||||||||||
Primary Practice Address | 3495 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909-6814 United States Phone: 321-409-2828 | Fax: | ||||||||||||||||
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