Provider Demographics
NPI:1558647982
Name:WALGREENS
Entity type:Organization
Organization Name:WALGREENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:KALIOPE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ZAGORIANOS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:513-604-0036
Mailing Address - Street 1:5958 GLENNGATE CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-4969
Mailing Address - Country:US
Mailing Address - Phone:513-604-0036
Mailing Address - Fax:
Practice Address - Street 1:7804 CINCINNATI DAYTON RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6003
Practice Address - Country:US
Practice Address - Phone:513-779-8302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032230053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy