Provider Demographics
NPI:1457804205
Name:WALGREENS CO.
Entity Type:Organization
Organization Name:WALGREENS CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIO
Authorized Official - Middle Name:SOUSA
Authorized Official - Last Name:DEMATOS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:516-376-8780
Mailing Address - Street 1:1803 ADLIN CT
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1656
Mailing Address - Country:US
Mailing Address - Phone:516-376-8780
Mailing Address - Fax:
Practice Address - Street 1:12 E JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3141
Practice Address - Country:US
Practice Address - Phone:516-739-2408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0618463336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy