NPI | 1891702809 |
---|---|
Doing Business As | WALGREENS #05974 |
Entity Type | Organization |
Authorized Contact | KIRA L TAYLOR Manager 217-709-2351 |
Organization Subpart ? | Yes |
Primary Taxonomy | 333600000X Pharmacy (Licence: MO 2000165876) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
3336C0003X Pharmacy Community/Retail Pharmacy | |
Enumeration Date | 2006-08-02 |
Last Update Date | 2022-05-03 |