Provider Information for 1033124169
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WALGREEN CO
Other Names:Doing Business As:WALGREENS #11085Organization Subpart: YES
NPI: 1033124169
Last Updated: 2023-11-03
Certification Date: 2023-11-03
Certification Date: 2023-11-03
Details
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NPI | 1033124169 | ||||||||||||||||||||||||
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 MS #790 DANVILLE, IL 61834-4509 United States Phone: 217-709-2351 | Fax:217-709-2344 | ||||||||||||||||||||||||
Primary Practice Address | 52482 INDIANA STATE ROUTE 933 SOUTH BEND, IN 46637-3852 United States Phone: 574-271-0357 | Fax:574-243-1516 | ||||||||||||||||||||||||
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