Provider Information for 1932116944
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WALGREEN CO
Other Names:Doing Business As:WALGREENS #03906Organization Subpart: YES
NPI: 1932116944
Last Updated: 2023-11-09
Certification Date: 2023-11-09
Certification Date: 2023-11-09
Details
| Name | Value | ||||||||||||||||
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| NPI | 1932116944 | ||||||||||||||||
| Enumeration Date | 2006-08-02 | ||||||||||||||||
| 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 | 7339 GRAVOIS AVE SAINT LOUIS, MO 63116-1040 United States Phone: 314-752-0722 | Fax: | ||||||||||||||||
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