Organization
WALGREENS CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK WAGNER (PRESIDENT)
18007630547
Entity
Organization
Contact information
Practice address
690 NW 183RD ST, MIAMI, FL 33169-4470
(305) 249-6792
Mailing address
690 NW 183RD ST, MIAMI, FL 33169-4470
(305) 249-6792
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PS36358
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022098100
—
FL
Enumeration date
11/11/2011
Last updated
11/11/2011
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