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General NPI Number Information
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NPI Number | 1558702605
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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 | 07/17/2013
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Last Update Date | 07/17/2013
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Provider Practice Location Address
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Address Line | 3994 TYRONE BLVD
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City | SAINT PETERSBURG
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State | FL
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Zip | 33709
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Country | US
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Telephone | 727-343-2221
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 MCCLURE CT
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City | TALLAHASSEE
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State | FL
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Zip | 32312-9011
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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. ANNETTE LEFRANC
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Credential |
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Telephone | 850-591-6213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | PS50538
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License Number State | FL
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