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General NPI Number Information
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NPI Number | 1538441340
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Entity Type | Organization
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Legal Business Name | WALGREEN
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 1835 PEMBERTON LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1577
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Country | US
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Telephone | 317-895-0023
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Fax |
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Provider Business Mailing Address
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Address Line | 1835 PEMBERTON LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1577
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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 | PHARMACIST
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Name | DR. KRUNAL B PATEL
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Credential |
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Telephone | 317-209-4899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | 26023742A
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License Number State | IN
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