Provider Demographics
NPI:1477823037
Name:WALGREENS PHARMACY
Entity Type:Organization
Organization Name:WALGREENS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ASARE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:813-431-2533
Mailing Address - Street 1:6503 W WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-2207
Mailing Address - Country:US
Mailing Address - Phone:813-887-3166
Mailing Address - Fax:813-887-3258
Practice Address - Street 1:6503 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-2207
Practice Address - Country:US
Practice Address - Phone:813-887-3166
Practice Address - Fax:813-887-3258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS322133336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy