Wallgreens

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

RPH52616 Issued in CA

Legal business name

WALLGREENS

Practice address

1414 El Camino Real
San Carlos, CA 94070-0000

Phone

(650) 637-9777

Fax

(650) 637-1012

NPI assigned

Sep 20, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Conja So-Rosillo, PHARMD

Title

Pharmacist

Phone

(650) 637-9777

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1154604841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 EL CAMINO REAL",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "94070",
            "telephone_number": "650-637-9777",
            "fax_number": "650-637-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 EL CAMINO REAL",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940700000",
            "telephone_number": "650-637-9777",
            "fax_number": "650-637-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLGREENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "SO-ROSILLO",
        "authorized_official_first_name": "CONJA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "650-637-9777",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "RPH52616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leilani Anne Wagner, DC
• Walgreen Co
• Walgreen Co
• Jamica N Walker
• Jody Pamela Wallace, MS, CGC
• Amy Wang, DTCM
• Buer Wang, LAC
• Zhimiao Wang
• Joseph M Warner, AMFT 455756
• Annette Waters

• Community Health Clinic/Center in San Carlos, CA
• Providers in San Carlos, CA by specialty
• Community Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.