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General NPI Number Information
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NPI Number | 1720363708
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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 | 10/20/2011
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 7787 SUNRISE BLVD
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95610-2309
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Country | US
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Telephone | 916-722-1982
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Fax |
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Provider Business Mailing Address
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Address Line | 7787 SUNRISE BLVD
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95610-2309
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Country | US
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Telephone | 916-722-1982
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Fax |
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Authorized Official
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Title or Position | PAHRMACIST
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Name | MRS. MOUMITA DAS I
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Credential | RPH
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Telephone | 916-722-1982
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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 | 59342
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License Number State | CA
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