Organization
WALGREENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT CHARLES LEWIS (RPH)
(815) 223-7853
Entity
Organization
Contact information
Practice address
1033 SHOOTING PARK ROAD, PERU, IL 61354
(815) 223-7853
Mailing address
1033 SHOOTING PARK RD, PERU, IL 61354-1870
(815) 223-7853
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
054006628
IL
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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