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General NPI Number Information
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NPI Number | 1992081988
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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 | 10/23/2011
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Last Update Date | 10/23/2011
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Provider Practice Location Address
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Address Line | 1275 N GALENA AVE
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City | DIXON
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State | IL
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Zip | 61021-1001
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Country | US
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Telephone | 815-288-7844
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Fax | 815-288-6953
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Provider Business Mailing Address
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Address Line | 822 E MORGAN ST 822 E. MORGAN ST.
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City | DIXON
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State | IL
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Zip | 61021-2260
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Country | US
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Telephone | 815-973-6327
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Fax |
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Authorized Official
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Title or Position | STAFF PHARMACIST
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Name | MR. STEVEN C OSTER
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Credential | RPH
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Telephone | 815-973-6327
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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 | 051.033825
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License Number State | IL
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