Provider Information for 1548520844
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WALGREEN CO
Other Names:Doing Business As:WALGREENS #15109Organization Subpart: YES
NPI: 1548520844
Last Updated: 2022-04-26
Certification Date: 2022-04-26
Certification Date: 2022-04-26
Details
| Name | Value | ||||||||||||||||
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| NPI | 1548520844 | ||||||||||||||||
| Enumeration Date | 2012-05-21 | ||||||||||||||||
| 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 | 4327 JEFFERSON HWY JEFFERSON, LA 70121-1519 United States Phone: 504-731-1431 | Fax:504-731-7113 | ||||||||||||||||
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