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General NPI Number Information
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NPI Number | 1376828962
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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 | 10/15/2011
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Last Update Date | 10/15/2011
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Provider Practice Location Address
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Address Line | 699 BROADWAY
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City | BAYONNE
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State | NJ
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Zip | 07002-4724
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Country | US
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Telephone | 201-243-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 133 W 15TH ST 2ND FLOOR
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City | BAYONNE
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State | NJ
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Zip | 07002-1427
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Country | US
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Telephone | 201-215-8214
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Fax |
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Authorized Official
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Title or Position | PHARMACY TECHNICIAN
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Name | SAM SOLIMAN
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Credential |
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Telephone | 201-215-8214
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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 | 28RW00210000
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License Number State | NJ
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