| NPI | 1790942019 |
|---|---|
| Other Name | WALGREENS # 10456 |
| Entity Type | Organization |
| Authorized Contact | KIRA L TAYLOR Manager 217-709-2351 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CO PDO-741) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2023-10-27 |