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General NPI Number Information
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NPI Number | 1750650925
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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 | 12/18/2011
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Last Update Date | 12/18/2011
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Provider Practice Location Address
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Address Line | 3009 W MARKET ST
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City | FAIRLAWN
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State | OH
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Zip | 44333-3610
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Country | US
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Telephone | 330-867-1946
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Fax |
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Provider Business Mailing Address
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Address Line | 3009 W MARKET ST
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City | FAIRLAWN
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State | OH
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Zip | 44333-3610
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Country | US
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Telephone | 330-867-1946
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Fax |
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Authorized Official
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Title or Position | R.PN
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Name | ANNE M BEYMAN
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Credential |
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Telephone | 330-867-1946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 03321689
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License Number State | OH
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