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General NPI Number Information
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NPI Number | 1932515939
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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 | 07/10/2014
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 875 TIOGUE AVE
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City | COVENTRY
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State | RI
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Zip | 02816-6300
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Country | US
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Telephone | 401-822-7602
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Fax |
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Provider Business Mailing Address
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Address Line | 875 TIOGUE AVE
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City | COVENTRY
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State | RI
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Zip | 02816-6300
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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 | STORE MANAGER
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Name | KATIE LANG
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Credential |
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Telephone | 401-822-7602
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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 | RPH05323
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License Number State | RI
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