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NPI Code Detail

MEDICARE: WALGREEEN CO.

MEDICARE: WALGREEEN CO.
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
13336C0003XCommunity/Retail PharmacyPS33463FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538488945
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALGREEEN CO.
Provider Business Mailing Address
First Line : 9700 ARGYLE FOREST BLVD.
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32222-7918
Country : US
Telephone Number : 904-778-0871
Fax Number :
Provider Business Practice Location Address
First Line : 9700 ARGYLE FOREST BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32222-2809
Country : US
Telephone Number : 904-778-0871
Fax Number :
Authorized Official
Title or Position : PHARMACIST
Name : MR. MANDEL JERMAINE HEARNS
Credential : PHARM. D
Telephone Number : 904-778-0871
Provider Enumeration Date : 05/25/2010
Last Update Date : 05/25/2010

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Directions to “WALGREEEN CO. ” Practice Location

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