Provider Demographics
NPI:1457627150
Name:WALGREENS
Entity Type:Organization
Organization Name:WALGREENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERVAT
Authorized Official - Middle Name:S
Authorized Official - Last Name:MIKHAEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-997-2837
Mailing Address - Street 1:7490 HAGGERTY RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-1067
Mailing Address - Country:US
Mailing Address - Phone:248-661-4409
Mailing Address - Fax:
Practice Address - Street 1:7490 HAGGERTY RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-1067
Practice Address - Country:US
Practice Address - Phone:248-661-4409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty