Organization
WALGREENS PHARMACY #12427
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN BOUCHARD R.PH (MANAGER)
(217) 546-9558
Entity
Organization
Contact information
Practice address
2305 W MONROE, SPRINGFIELD, IL 62704
(217) 546-9558
Mailing address
2305 W MONROE, SPRINGFIELD, IL 62704
(217) 546-9558
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
051-031981
IL
Other
Enumeration date
10/13/2011
Last updated
10/13/2011
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