Provider Demographics
NPI:1922217363
Name:WALGREENS CORPORATION
Entity Type:Organization
Organization Name:WALGREENS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARMACY DISTRICT SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:LARIVIERA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:603-472-2346
Mailing Address - Street 1:37 AMBLE RD
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1931
Mailing Address - Country:US
Mailing Address - Phone:978-256-8731
Mailing Address - Fax:
Practice Address - Street 1:440 WEST ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-2453
Practice Address - Country:US
Practice Address - Phone:603-357-1002
Practice Address - Fax:603-352-6974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR10573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy