| NPI | 1720399652 | 
|---|---|
| Doing Business As | WALGREENS #12490 | 
| Entity Type | Organization | 
| Authorized Contact | KIRA TAYLOR Manager 217-709-2351 | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 333600000X Pharmacy (Licence: NY 030284) | 
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy | 
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2010-06-25 | 
| Last Update Date | 2022-04-04 |