# WALGREEN

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

## Provider details

- **NPI number:** 1932483484
- **Authorized official:** RICHARD ANDERSON (PHARMACY MANAGER)
- **Authorized official phone:** (573) 449-8330

## Contact information

- **Practice address:** 1000 CLUB VILLAGE DR, COLUMBIA, MO 65203-4405
- **Practice address phone:** (573) 449-8330
- **Mailing address:** 1000 CLUB VILLAGE DR, COLUMBIA, MO 65203-4405
- **Mailing address phone:** (573) 449-8330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 2007026743 | MO | Yes |

## Other

- **Enumeration date:** 10/03/2011
- **Last updated:** 10/03/2011