Organization
WALGREENS
Active
Other names
Walgreens
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY LOWELL HAWKES PHARMD (PHARMACY MANAGER)
(801) 616-5223
Entity
Organization
Contact information
Practice address
1315 N STATE ST, PROVO, UT 84604-2416
(801) 616-5223
Mailing address
1315 N STATE ST, PROVO, UT 84604-2416
(801) 616-5223
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
6609157-1701
UT
Other
Enumeration date
12/03/2011
Last updated
12/03/2011
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