| NPI | 1275774473 |
|---|---|
| Doing Business As | WALGREENS #12114 |
| Entity Type | Organization |
| Authorized Contact | KIRA TAYLOR Manager 217-709-2351 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MO 2009009818) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2022-03-29 |