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Organization
WALGREENS
Active
Organization
WALGREENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADA VANDYKE PHARMD (STAFF PHARMACIST)
(614) 584-6965
Entity
Organization
Contact information
Practice address
5716 ATON AVE, WESTWORTH VILLAGE, TX 76114
(614) 584-6965
Mailing address
3809 E BELKNAP, FORT WORTH, TX 76111
(817) 834-7283
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
52182
TX
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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