Healthcare Provider Details

I. General information

NPI: 1912752031
Provider Name (Legal Business Name): WALGREENS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2024
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9625 WHITE SETTLEMENT RD
FORT WORTH TX
76108-4406
US

IV. Provider business mailing address

7019 ROVATO DR
ARLINGTON TX
76001-6215
US

V. Phone/Fax

Practice location:
  • Phone: 817-367-3469
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: OSEYI ITOYA
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 682-240-3307