Organization
SENIORMED LLC
Active
Parent organization
WALGREEN CO.
Other names
Seniormed Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREEN CO.
Authorized official
MR. KERMIT R CRAWFORD (SR VICE PRESIDENT)
(847) 914-3154
Entity
Organization
Contact information
Practice address
12505 STARKEY RD, SUITE C, LARGO, FL 33773-2621
(727) 230-0839
Mailing address
1901 E VOORHEES ST, MS 720, DANVILLE, IL 61834-4509
(217) 554-8964
(217) 554-8546
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
PH23017
FL
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1029900
NCPDP
—
Enumeration date
10/02/2007
Last updated
12/10/2007
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