MEDICARE: WALGREENS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	18891	TX

General Provider Information

NPI Number	:	1255669081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALGREENS

Provider Business Mailing Address
First Line	:	9150 S DAIRY ASHFORD ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77099-1218
Country	:	US
Telephone Number	:	281-498-3734
Fax Number	:

Provider Business Practice Location Address
First Line	:	9150 S DAIRY ASHFORD ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77099-1218
Country	:	US
Telephone Number	:	281-498-3734
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	MR. LARRY RAMOS
Credential	:
Telephone Number	:	281-498-3734

Provider Enumeration Date	:	12/07/2009
Last Update Date	:	12/07/2009

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Directions to “WALGREENS ” Practice Location

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