# WALGREEN CO

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WALGREENS BOOTS ALLIANCE INC
- **Other names:** WALGREENS \#10835
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558552729
- **Legal business name:** WALGREENS BOOTS ALLIANCE INC
- **Authorized official:** JENNIFER PONCE (MANAGER)
- **Authorized official phone:** (847) 527-2489

## Contact information

- **Practice address:** 906 MARION AVE., MCCOMB, MS 39648-2040
- **Practice address phone:** (601) 684-7976
- **Practice address fax:** (601) 684-5372
- **Mailing address:** 1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4515
- **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 | 0743901.2 | MS | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 01/12/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02628368 | — | MS |
| 01 | — | 09106315 | MS MEDICAID (DME) | MS |
| 01 | — | 2586951 | NCPDP | — |