Provider Demographics
NPI:1033584933
Name:WALGREENS
Entity Type:Organization
Organization Name:WALGREENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-235-6066
Mailing Address - Street 1:1401 E NAVAJO DR
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-9433
Mailing Address - Country:US
Mailing Address - Phone:973-373-1353
Mailing Address - Fax:
Practice Address - Street 1:801 W JOE HARVEY BLVD
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-0815
Practice Address - Country:US
Practice Address - Phone:575-392-0053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service