Provider Demographics
NPI:1457753238
Name:WALGREENS PHARMACY
Entity Type:Organization
Organization Name:WALGREENS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LUWANDA
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:GARBUTT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:562-281-9899
Mailing Address - Street 1:11330 215TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90715-2084
Mailing Address - Country:US
Mailing Address - Phone:562-281-9899
Mailing Address - Fax:
Practice Address - Street 1:2690 PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-7038
Practice Address - Country:US
Practice Address - Phone:310-517-0351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty