Organization
WALGREEN CO.
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens Specialty Pharmacy #15309
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
2100 LYNDALE AVE S STE A, MINNEAPOLIS, MN 55405
(612) 872-7808
(612) 874-1084
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(847) 527-2489
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
263842
MN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013280403
—
IA
05
—
1013280403
—
SD
05
—
1013280403
—
WI
01
—
2431271
NCPDP
MN
Enumeration date
02/15/2012
Last updated
11/06/2024
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