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General NPI Number Information
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NPI Number | 1245588698
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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 | 08/16/2012
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Last Update Date | 08/16/2012
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Provider Practice Location Address
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Address Line | 406 E FORDHAM RD
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City | BRONX
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State | NY
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Zip | 10458-5010
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Country | US
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Telephone | 718-220-2461
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Fax |
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Provider Business Mailing Address
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Address Line | 406 E FORDHAM RD
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City | BRONX
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State | NY
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Zip | 10458-5010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXA
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Name | MS. SOPHIA SOSA
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Credential |
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Telephone | 718-220-2461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 530100064861541
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License Number State | NY
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