# WALGREENS 11079

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WALGREEN CO./ILL.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1023455383
- **Legal business name:** WALGREEN CO./ILL.
- **Authorized official:** JON REITZ (MARKET PHARMACY DIRECTOR)
- **Authorized official phone:** (302) 366-0335

## Contact information

- **Practice address:** 38627 BENRO DR, DELMAR, DE 19940-3572
- **Practice address phone:** (302) 907-1010
- **Practice address fax:** (302) 907-1006
- **Mailing address:** 200 WILMOT RD, DEERFIELD, IL 60015-4620
- **Mailing address phone:** (302) 366-0335
- **Mailing address fax:** (302) 453-3168

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 380101061159913 | DE | Yes |

## Other

- **Enumeration date:** 05/28/2013
- **Last updated:** 05/28/2013