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Organization
WALGREEN CO
Active
Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens Specialty Pharmacy #13832
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
4339 DI PAOLO CTR, GLENVIEW, IL 60025-5202
(847) 299-1920
(847) 299-1943
Mailing address
1901 E VOORHEES ST, MS #790, DANVILLE, IL 61834-4509
(847) 527-2489
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
054016020
IL
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1276740
—
LA
01
—
1467516
NCPDP
—
05
—
1518982180
—
IA
05
—
1518982180
—
MO
05
—
172250002
—
ME
05
—
200841780A
—
IN
05
—
4904689
—
MI
05
—
6030399
—
WA
05
—
8532072
—
SD
Enumeration date
07/13/2006
Last updated
12/02/2024
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