Provider Information for 1568679439
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WALGREEN CO
Other Names:Doing Business As:WALGREENS #10319Organization Subpart: YES
NPI: 1568679439
Last Updated: 2023-11-08
Certification Date: 2023-11-08
Certification Date: 2023-11-08
Details
Name | Value | ||||||||||||||||
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NPI | 1568679439 | ||||||||||||||||
Enumeration Date | 2007-05-17 | ||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||
Status | Active | ||||||||||||||||
Authorized Official Information | Name: KIRA L 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 | 472 LINCOLN ST. WORCESTER, MA 01605-1917 United States Phone: 508-856-7923 | Fax:508-856-7929 | ||||||||||||||||
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