Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens #15770
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
1150 S GARNETT RD, TULSA, OK 74128-1822
(918) 437-9677
(918) 234-7861
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
24828
OK
333600000X
Pharmacy
24828
OK
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100236540D
—
OK
01
—
200077890U
MEDICAID DME
OK
01
—
3711644
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
400522489
MEDICARE FLU
OK
Enumeration date
10/25/2006
Last updated
05/02/2022
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