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	PS44326	FL

General Provider Information

NPI Number	:	1831460328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALGREENS

Provider Business Mailing Address
First Line	:	4703 POINT O WOODS DR
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-6940
Country	:	US
Telephone Number	:	813-298-0355
Fax Number	:

Provider Business Practice Location Address
First Line	:	4703 POINT O WOODS DR
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-6940
Country	:	US
Telephone Number	:	813-298-0355
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED PHARMACIST
Name	:	MRS. YELENA YEVSTRATOVA
Credential	:	RPH
Telephone Number	:	813-977-0651

Provider Enumeration Date	:	01/16/2012
Last Update Date	:	02/04/2012

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