| NPI | 1053507210 |
|---|---|
| Other Name | WALGREENS # 10309 |
| Entity Type | Organization |
| Authorized Contact | KIRA L TAYLOR Manager 217-709-2351 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: CT PCY.0002100) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2023-10-30 |