Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Murphy Drug #15804, Powered by Walgreens
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
1357 VETERANS MEMORIAL BLVD, EUPORA, MS 39744-2064
(662) 258-2631
(662) 258-3868
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4515
(847) 527-2489
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
01855/01.1
MS
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
E5353
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01587314
—
MS
05
—
04681717
—
MS
01
—
2503301
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/03/2006
Last updated
09/09/2025
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