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Organization
WALGREEN CO
Active
Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #17942
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
KIRA TAYLOR (MANAGER)
(217) 709-2351
Entity
Organization
Contact information
Practice address
9616 COUNTY ROAD 403, CHARLESTOWN, IN 47111
(812) 256-6368
(812) 256-7840
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(217) 709-2351
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
60006659A
IN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568813
NCPDP
IN
05
—
300012342
—
IN
01
—
60006659A
BOARD OF PHARMACY
IN
Enumeration date
07/26/2017
Last updated
05/23/2022
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