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NPI Code Detail

MEDICARE: WALGREENS

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
13336C0003XCommunity/Retail Pharmacy51970CA

General Provider Information

NPI Number : 1598041097
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALGREENS
Provider Business Mailing Address
First Line : 1086 W ARROW HWY
Second Line :
City : SAN DIMAS
State : CA
Zip : 91773-2492
Country : US
Telephone Number : 909-305-1352
Fax Number :
Provider Business Practice Location Address
First Line : 1086 W ARROW HWY
Second Line :
City : SAN DIMAS
State : CA
Zip : 91773-2492
Country : US
Telephone Number : 909-305-1352
Fax Number :
Authorized Official
Title or Position : PHARMACIST
Name : CHAU MINH VO
Credential :
Telephone Number : 909-305-1352
Provider Enumeration Date : 10/27/2011
Last Update Date : 10/27/2011

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Directions to “WALGREENS ” Practice Location

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