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General NPI Number Information
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NPI Number | 1528337516
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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 | 12/20/2011
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Last Update Date | 12/20/2011
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Provider Practice Location Address
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Address Line | 1800 E IMPERIAL HWY STE 150
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City | BREA
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State | CA
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Zip | 92821-6015
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Country | US
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Telephone | 714-507-5706
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 E IMPERIAL HWY STE 150
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City | BREA
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State | CA
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Zip | 92821-6015
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Country | US
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Telephone | 714-507-5706
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Fax |
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Authorized Official
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Title or Position | PHARMACY SUPERVISOR
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Name | MR. ROBERT HYUP LEE
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Credential |
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Telephone | 714-507-5706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH39889
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License Number State | CA
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