Walgreens

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PS47625 Issued in FL

Legal business name

WALGREENS

Practice address

1661 NW Saint Lucie West Blvd
Port St Lucie, FL 34986-2106

Phone

(772) 873-1892

NPI assigned

Sep 15, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Kara Denyse Menesick, PHARM D.

Title

Registered Immunizing Pharmacist

Phone

(772) 215-2490

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1215219241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 NE SABAL PALM WAY",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349576509",
            "telephone_number": "772-215-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 NW SAINT LUCIE WEST BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862106",
            "telephone_number": "772-873-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "MENESICK",
        "authorized_official_first_name": "KARA",
        "authorized_official_middle_name": "DENYSE",
        "authorized_official_title_or_position": "REGISTERED IMMUNIZING PHARMACIST",
        "authorized_official_telephone_number": "772-215-2490",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHARM D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PS47625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #06383)
• Walgreen Co (Walgreens #04804)
• Walgreen Co (Walgreens #04001)
• Walgreen Co (Walgreens #05465)
• Walgreen Co (Walgreens #03110)
• Walgreens Pharmacy
• Colleen Walizer, M.S., BA
• Aida Walker
• Nadine Eugenie Walker, PHARMACIST
• Taneia R. Walker

• Community/Retail Pharmacy in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.