Provider Demographics
NPI:1639453251
Name:WALGREENS
Entity Type:Organization
Organization Name:WALGREENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGESTERED PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:781-665-1329
Mailing Address - Street 1:897 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-2322
Mailing Address - Country:US
Mailing Address - Phone:781-665-1329
Mailing Address - Fax:781-662-3458
Practice Address - Street 1:897 MAIN ST
Practice Address - Street 2:1
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-2322
Practice Address - Country:US
Practice Address - Phone:781-665-1329
Practice Address - Fax:781-662-3458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH22491261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty