WALGREEN CO
115 Vernon St
Lagrange, GA 30240
706-812-9852
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 332B00000X | Suppliers - Durable Medical Equipment & Medical Supplies - | ||
N | 3336C0003X | Suppliers - Pharmacy | ||
Y | 333600000X | Suppliers - Pharmacy | GA | PHRE009036 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
264028415A | GA | MEDICAID | |
264028415B DME | GA | MEDICAID | |
NCPDP | 1154309 | OTHER |