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General NPI Number Information
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NPI Number | 1023393543
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Entity Type | Organization
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Legal Business Name | WALGREENS
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Dates
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Enumeration Date | 10/16/2011
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Last Update Date | 10/16/2011
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Provider Practice Location Address
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Address Line | 119 FORKS OF THE RIVER PKWY
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City | SEVIERVILLE
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State | TN
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Zip | 37862-3435
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Country | US
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Telephone | 865-908-8755
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Fax | 865-908-8771
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Provider Business Mailing Address
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Address Line | 119 FORKS OF THE RIVER PKWY
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City | SEVIERVILLE
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State | TN
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Zip | 37862-3435
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Country | US
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Telephone | 865-908-8755
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Fax | 865-908-8771
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. PEGGY ANN LUCAS
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Credential | PHARMD
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Telephone | 865-908-8755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 35747
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License Number State | TN
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