Provider Demographics
NPI:1578015160
Name:WALGREENS
Entity Type:Organization
Organization Name:WALGREENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAGALI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTISON
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:757-867-7109
Mailing Address - Street 1:99 TIDE MILL LN
Mailing Address - Street 2:APARTMENT 96
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2764
Mailing Address - Country:US
Mailing Address - Phone:571-331-1893
Mailing Address - Fax:
Practice Address - Street 1:600 J CLYDE MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-1820
Practice Address - Country:US
Practice Address - Phone:757-599-6264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-29
Last Update Date:2016-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214980183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty