Provider Demographics
NPI:1750651337
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:ANGELA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:CHALMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-585-6810
Mailing Address - Street 1:4007 W SAN MIGUEL ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-5725
Mailing Address - Country:US
Mailing Address - Phone:813-340-7022
Mailing Address - Fax:
Practice Address - Street 1:2295 E BAY DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-2324
Practice Address - Country:US
Practice Address - Phone:727-585-6810
Practice Address - Fax:
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
FLPS25569333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy