# WALGREEN CO

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WALGREENS BOOTS ALLIANCE INC
- **Other names:** Walgreens Specialty Pharmacy \#16422
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1134582398
- **Legal business name:** WALGREENS BOOTS ALLIANCE INC
- **Authorized official:** JENNIFER PONCE (MANAGER)
- **Authorized official phone:** (847) 527-2489

## Contact information

- **Practice address:** 114 W 3RD AVE, STE 114, COLUMBUS, OH 43201-3211
- **Practice address phone:** (614) 456-1108
- **Practice address fax:** (614) 456-1209
- **Mailing address:** 1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
- **Mailing address phone:** (847) 527-2489
- **Mailing address fax:** (217) 709-2344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | 022595850 | OH | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 04/04/2016
- **Last updated:** 12/04/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0188664 | — | OH |
| 01 | — | 3684265 | NCPDP | OH |