Provider Demographics
NPI:1245630706
Name:WALGREENS CO.
Entity type:Organization
Organization Name:WALGREENS CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:RODZEVIK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:631-275-3889
Mailing Address - Street 1:2720 SOUTH BLVD
Mailing Address - Street 2:APT 122
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-0004
Mailing Address - Country:US
Mailing Address - Phone:631-275-3889
Mailing Address - Fax:
Practice Address - Street 1:2720 SOUTH BLVD
Practice Address - Street 2:APT 122
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-0004
Practice Address - Country:US
Practice Address - Phone:631-275-3889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC245453336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy