Organization
WALTER LAGESTEE INCORPORATED
Active
Other names
Walt's Pharmacy #4
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK J EGAN PHARMACIST (THIRD PARTY COORDINATOR)
(708) 957-2974
Entity
Organization
Contact information
Practice address
1100 E EXCHANGE ST, CRETE, IL 60417-3433
(708) 672-9175
(708) 672-6845
Mailing address
1100 E EXCHANGE ST, CRETE, IL 60417-3433
(708) 672-9175
(708) 672-6845
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054-11905
IL
Other
Enumeration date
10/26/2006
Last updated
11/16/2012
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