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General NPI Number Information
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NPI Number | 1760763015
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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 | 08/31/2011
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 455 WAKEFIELD TRCE
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City | ALPHARETTA
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State | GA
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Zip | 30004-0890
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Country | US
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Telephone | 404-395-3225
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Fax |
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Provider Business Mailing Address
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Address Line | 455 WAKEFIELD TRCE
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City | ALPHARETTA
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State | GA
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Zip | 30004-0890
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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 | SENIOR PHARMACY TECHNICIAN
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Name | MARCUS DENNIS
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Credential |
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Telephone | 404-395-3225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHTC001709
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License Number State | GA
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