Organization
WALTER LAGESTEE INCORPORATED
Active
Other names
Walt's Pharmacy #2
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK J EGAN PHARMACIST (THIRD PARTY COORDINATOR)
(708) 957-2974
Entity
Organization
Contact information
Practice address
2345 183RD ST, HOMEWOOD, IL 60430-3140
(708) 957-2974
(708) 957-9331
Mailing address
2345 183RD ST, HOMEWOOD, IL 60430-3140
(708) 957-2974
(708) 957-9331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054-11907
IL
Other
Enumeration date
10/26/2006
Last updated
11/16/2012
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