| NPI | 1104114388 |
|---|---|
| Doing Business As | WALGREENS #12979 |
| Entity Type | Organization |
| Authorized Contact | KIRA TAYLOR Manager 217-709-2351 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: SC 50013544) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2022-04-08 |