Provider Demographics
NPI:1841577327
Name:WALGREEN CO.
Entity Type:Organization
Organization Name:WALGREEN CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PHARMAICST
Authorized Official - Prefix:
Authorized Official - First Name:JORG
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:LARGENT
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:770-509-5629
Mailing Address - Street 1:3033 JOHNSON FERRY RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-5678
Mailing Address - Country:US
Mailing Address - Phone:770-518-4263
Mailing Address - Fax:770-518-6608
Practice Address - Street 1:3033 JOHNSON FERRY RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5678
Practice Address - Country:US
Practice Address - Phone:770-518-4263
Practice Address - Fax:770-518-6608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021043251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare