| NPI | 1083971790 | 
|---|---|
| Doing Business As | JIM MYERS, A WALGREENS PHARMACY #15449 | 
| Entity Type | Organization | 
| Authorized Contact | KIRA TAYLOR Manager 217-709-2351  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 333600000X Pharmacy (Licence: AL 113924)  | 
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies | 
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2012-04-19 | 
| Last Update Date | 2022-04-28 |