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General NPI Number Information
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NPI Number | 1679890396
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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 | 04/21/2010
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Last Update Date | 04/21/2010
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Provider Practice Location Address
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Address Line | 2908 EASTBOURNE LN
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City | FLOWER MOUND
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State | TX
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Zip | 75022-0900
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Country | US
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Telephone | 972-874-8496
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Fax | 972-874-8496
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Provider Business Mailing Address
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Address Line | 2050 LONG PRAIRIE RD
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City | FLOWER MOUND
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State | TX
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Zip | 75022-4221
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Country | US
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Telephone | 972-355-4831
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Fax | 972-355-4482
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Authorized Official
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Title or Position | RPH
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Name | DIEM KHANH NGUYYEN
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Credential |
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Telephone | 972-355-4831
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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 | 33504
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License Number State | TX
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