Organization
WALTER LAGESTEE INCORPORATED
Active
Other names
Walt's Pharmacy #1
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
16145 S STATE ST, SOUTH HOLLAND, IL 60473-1237
(708) 333-4492
(708) 333-8713
Mailing address
16145 STATE ST, SOUTH HOLLAND, IL 60473-1287
(708) 333-4492
(708) 333-8713
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054-11904
IL
Other
Enumeration date
10/26/2006
Last updated
11/20/2012
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