| NPI | 1275051658 |
|---|---|
| Doing Business As | WALGREENS #17612 |
| Entity Type | Organization |
| Authorized Contact | KIRA TAYLOR Manager 217-709-2351 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MA DS90156) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2022-05-13 |