| NPI | 1588820807 |
|---|---|
| Doing Business As | WALGREENS #11742 |
| Entity Type | Organization |
| Authorized Contact | JENNIFER PONCE Manager 224-475-5702 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: ME PH50001350) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2026-01-29 |