# WALGREEN CO

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WALGREENS BOOTS ALLIANCE INC
- **Other names:** Walgreens \#15730
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1487738522
- **Legal business name:** WALGREENS BOOTS ALLIANCE INC
- **Authorized official:** KIRA TAYLOR (MANAGER)
- **Authorized official phone:** (217) 709-2351

## Contact information

- **Practice address:** 3222 S MAIN ST, JOPLIN, MO 64804-3824
- **Practice address phone:** (417) 624-6300
- **Practice address fax:** (417) 624-5818
- **Mailing address:** 1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
- **Mailing address phone:** (217) 709-2351
- **Mailing address fax:** (217) 709-2344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | — | — |
| 333600000X | Pharmacy | 2017006070 | MO | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | — | — |

## Other

- **Enumeration date:** 10/25/2006
- **Last updated:** 05/02/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100236540A | — | OK |
| 01 | — | 100434660A | MEDICAID KS | KS |
| 01 | — | 200077890T | MEDICAID DME | MO |
| 01 | — | 2613784 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 01 | — | 400522489 | MEDICARE FLU | OK |
| 05 | — | 600051726 | — | MO |