Provider Demographics
NPI:1689941882
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:LORI
Authorized Official - Middle Name:WILLIAMSON
Authorized Official - Last Name:CROWE
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:205-425-1757
Mailing Address - Street 1:1815 9TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35020-3421
Mailing Address - Country:US
Mailing Address - Phone:205-425-1757
Mailing Address - Fax:205-425-8103
Practice Address - Street 1:1815 9TH AVE N
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35020-3421
Practice Address - Country:US
Practice Address - Phone:205-425-1757
Practice Address - Fax:205-425-8103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL361924025251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health