NPI | 1902321128 |
---|---|
Doing Business As | WALGREENS #17502 |
Entity Type | Organization |
Authorized Contact | JENNIFER PONCE Manager 224-475-5702 |
Organization Subpart ? | Yes |
Primary Taxonomy | 333600000X Pharmacy (Licence: MA DS90177) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
3336C0003X Pharmacy, Community/Retail Pharmacy | |
Enumeration Date | 2017-08-09 |
Last Update Date | 2025-07-24 |