# WALGREEN CO

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WALGREENS BOOTS ALLIANCE INC
- **Other names:** WALGREENS \#10153
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1679676662
- **Legal business name:** WALGREENS BOOTS ALLIANCE INC
- **Authorized official:** JENNIFER PONCE (MANAGER)
- **Authorized official phone:** (847) 527-2489

## Contact information

- **Practice address:** 110 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-4818
- **Practice address phone:** (573) 776-1476
- **Practice address fax:** (573) 776-7549
- **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 | — | — | — |
| 333600000X | Pharmacy | 2006027140 | MO | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | — | — |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 11/20/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 164124716 | — | AR |
| 01 | — | 2637025 | NCPDP | — |
| 05 | — | 606266906 | — | MO |
| 05 | — | 626266902 | — | MO |