MEDICARE: WALGREENS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1215242466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALGREENS

Provider Business Mailing Address
First Line	:	114 ORANGE BLOSSOM CT
Second Line	:
City	:	BELLE CHASSE
State	:	LA
Zip	:	70037-1649
Country	:	US
Telephone Number	:	504-236-2695
Fax Number	:

Provider Business Practice Location Address
First Line	:	11297 LAKE FOREST BLVD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70128-2822
Country	:	US
Telephone Number	:	504-248-2898
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	MS. KELLIE MICHELLE BYRD
Credential	:	PHARMD
Telephone Number	:	504-236-2695

Provider Enumeration Date	:	08/12/2010
Last Update Date	:	08/12/2010

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Directions to “WALGREENS ” Practice Location

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