Provider Demographics
NPI:1538562137
Name:WALGREENS
Entity type:Organization
Organization Name:WALGREENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GEFFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-765-2066
Mailing Address - Street 1:2302 BUSCH RD
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:WA
Mailing Address - Zip Code:99113-9744
Mailing Address - Country:US
Mailing Address - Phone:425-765-2066
Mailing Address - Fax:
Practice Address - Street 1:2102 NEZ PERCE DR
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-4116
Practice Address - Country:US
Practice Address - Phone:208-743-4434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-27
Last Update Date:2014-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 60184032183500000X
IDP6624183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty