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NPI Code Detail

MEDICARE: WALGREENS PHARMACY 12293

MEDICARE: WALGREENS PHARMACY 12293
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
1333600000XPharmacy20312TX

General Provider Information

NPI Number : 1952743197
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALGREENS PHARMACY 12293
Provider Business Mailing Address
First Line : 203 W FERGUSON RD
Second Line :
City : MOUNT PLEASANT
State : TX
Zip : 75455-4809
Country : US
Telephone Number : 903-572-0486
Fax Number : 903-572-0380
Provider Business Practice Location Address
First Line : 203 W FERGUSON RD
Second Line :
City : MOUNT PLEASANT
State : TX
Zip : 75455-4809
Country : US
Telephone Number : 903-572-0486
Fax Number : 903-572-0380
Authorized Official
Title or Position : DISTRICT SUPERVISOR
Name : DR. RAJ M CHHADUA
Credential : PHARMD
Telephone Number : 972-822-2600
Provider Enumeration Date : 07/29/2013
Last Update Date : 07/29/2013

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Directions to “WALGREENS PHARMACY 12293 ” Practice Location

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