Provider Demographics
NPI:1689057044
Name:WALGREENS
Entity Type:Organization
Organization Name:WALGREENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEREME
Authorized Official - Middle Name:
Authorized Official - Last Name:YUHAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-245-0178
Mailing Address - Street 1:6606 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:MT
Mailing Address - Zip Code:59037-9211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1602 MAIN ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-4038
Practice Address - Country:US
Practice Address - Phone:406-245-0178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT320933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy