Organization
WALGREENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLYE HOLTGRAVE PHARM.D. (SUPERVISOR)
(314) 739-4503
Entity
Organization
Contact information
Practice address
4218 LINDELL BLVD, SAINT LOUIS, MO 63108-2916
(314) 371-4286
Mailing address
600 THIEBES RD, LABADIE, MO 63055-1710
(636) 751-5778
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
2013026259
MO
Other
Enumeration date
06/08/2014
Last updated
06/08/2014
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