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General NPI Number Information
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NPI Number | 1225313901
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Entity Type | Organization
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Legal Business Name | WALGREENS PHARMACY
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 399 WEST MAIN ST
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City | NORWICH
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State | CT
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Zip | 06360
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Country | US
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Telephone | 860-885-0389
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Fax |
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Provider Business Mailing Address
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Address Line | 399 WEST MAIN ST
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City | NORWICH
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State | CT
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Zip | 06360
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Country | US
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Telephone | 860-885-0389
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | TIMOTHY DONNARUMMO
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Credential | RPH
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Telephone | 860-885-0389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 08976
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License Number State | CT
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