Organization Name: | WALGREEN HOME CARE, INC |
NPI Number: | 1023104072 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TRENT E TAYLOR (PRESIDENT) |
Mailing Address: | 40 Capri Blvd Lake Havasu City |
State: | AZ US |
Postal Code: | 864035661 |
Phone Number: | 9286806800 |
Fax Number: | 9288547909 |
NPI Enumeration Date: | 10/05/2006 |
NPI Last Update Date: | 10/26/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |