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General NPI Number Information
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NPI Number | 1942817101
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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 | 09/30/2020
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Last Update Date | 09/30/2020
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Provider Practice Location Address
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Address Line | 1800 N MISSOURI ST STE 2
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-1750
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Country | US
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Telephone | 870-735-8987
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 N MISSOURI ST STE 2
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-1750
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Country | US
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Telephone | 870-735-8987
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | VINCE LOVELY
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Credential | PHARMD
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Telephone | 870-514-0274
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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 |
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License Number State |
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