Organization
WALGREENS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANASORN FOWLER PHD (PHARMACIST)
(702) 648-2732
Entity
Organization
Contact information
Practice address
6101 W LAKE MEAD BLVD, LAS VEGAS, NV 89108-2660
(702) 648-2732
(702) 648-2509
Mailing address
6080 W GOWAN RD, LAS VEGAS, NV 89108-4816
(702) 648-2732
(702) 648-2509
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
16568
NV
Other
Enumeration date
09/14/2011
Last updated
09/14/2011
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