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General NPI Number Information
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NPI Number | 1902176340
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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 | 01/03/2012
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 9202 N 56TH ST
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-5502
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Country | US
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Telephone | 813-985-8521
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Fax |
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Provider Business Mailing Address
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Address Line | 9202 N 56TH ST
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-5502
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Country | US
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Telephone | 813-985-8521
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | AMY THANH NGUYEN
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Credential |
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Telephone | 813-920-0343
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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 | PS40977
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License Number State | FL
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