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Organization
WALGREEN CO
Active
Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE
Other names
Walgreens #11274
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
2735 S STATE HIGHWAY 36, GATESVILLE, TX 76528-2715
(254) 865-2089
(254) 865-5498
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4515
(847) 527-2489
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
25729
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4546252
NCPDP
—
05
—
466428
—
TX
05
—
469317
—
TX
Enumeration date
09/27/2007
Last updated
05/29/2026
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