NPIMap

Organization Active NPI

Walgreens Pharmacy

  • Community/Retail Pharmacy
  • Port St Lucie, FL
National Provider Identifier
1376825315
Registry record updated Jul 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PS48022 Issued in FL
Legal business name
WALGREENS PHARMACY
Practice address
1025 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5386
Phone
(772) 335-4200
NPI assigned
Sep 15, 2011
Last updated
Jul 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2012

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

Authorized official

Name
Dr. Ulecia D Boldin, PHARM D
Title
Pharmacist
Phone
(772) 335-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PS48022 FL Primary

Addresses

Primary practice location

1025 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5386

Mailing address

1025 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5386
Phone (772) 335-4200

National Provider Directory

National Provider Directory

Locations

1025 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (772) 335-4200

NPI Registry JSON

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343433600000",
    "number": "1376825315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525386",
            "telephone_number": "772-335-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525386",
            "telephone_number": "772-335-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-15",
        "last_updated": "2012-07-28",
        "status": "A",
        "authorized_official_last_name": "BOLDIN",
        "authorized_official_first_name": "ULECIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "772-335-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PS48022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2012; 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.