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NPI Code Detail

MEDICARE: WALGREENS

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
13336C0003XCommunity/Retail PharmacyPS44826FL

General Provider Information

NPI Number : 1619258209
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALGREENS
Provider Business Mailing Address
First Line : 1903 STATE ROAD 60 E
Second Line :
City : LAKE WALES
State : FL
Zip : 33853-4329
Country : US
Telephone Number : 863-676-9496
Fax Number :
Provider Business Practice Location Address
First Line : 1903 STATE ROAD 60 E
Second Line :
City : LAKE WALES
State : FL
Zip : 33853-4329
Country : US
Telephone Number : 863-676-9496
Fax Number :
Authorized Official
Title or Position : PHARMACY MANAGER
Name : JOHN ROTH
Credential :
Telephone Number : 863-676-9496
Provider Enumeration Date : 09/08/2011
Last Update Date : 09/08/2011

Similar Medicare Providers

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Practice Location Address:
1903 STATE ROAD 60 E
LAKE WALES, FL
33853-4329
Practice Phone: 863-676-9496
Practice Fax:
1639296379 — MR. ASHISH K SHAH B.S. PHARMACY
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Practice Fax: 863-678-1829
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Practice Fax:
1982986444 — DR. NORSHAWNDRA MARIE SMITH PHARMD
Practice Location Address:
1903 STATE ROAD 60 E
LAKE WALES, FL
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1699058487 — HALIM FARAG RPH
Practice Location Address:
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Directions to “WALGREENS ” Practice Location

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