Provider Demographics
NPI:1891017216
Name:WALGREENS
Entity Type:Organization
Organization Name:WALGREENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:LOU
Authorized Official - Middle Name:
Authorized Official - Last Name:MORANDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-352-8548
Mailing Address - Street 1:1968 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-2813
Mailing Address - Country:US
Mailing Address - Phone:516-379-2182
Mailing Address - Fax:516-379-2055
Practice Address - Street 1:1968 GRAND AVE
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-2813
Practice Address - Country:US
Practice Address - Phone:516-379-2182
Practice Address - Fax:516-379-2055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty