# WALGREENS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639582604
- **Authorized official:** KELLYE HOLTGRAVE PHARM.D. (SUPERVISOR)
- **Authorized official phone:** (314) 739-4503

## Contact information

- **Practice address:** 4218 LINDELL BLVD, SAINT LOUIS, MO 63108-2916
- **Practice address phone:** (314) 371-4286
- **Mailing address:** 600 THIEBES RD, LABADIE, MO 63055-1710
- **Mailing address phone:** (636) 751-5778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 2013026259 | MO | Yes |

## Other

- **Enumeration date:** 06/08/2014
- **Last updated:** 06/08/2014