Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE
Other names
Walgreens Specialty Pharmacy #21319
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
2515 INWOOD RD STE 113, DALLAS, TX 75235-7400
(214) 630-6252
(214) 879-9999
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
—
—
333600000X
Pharmacy
Primary
27897
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
466800
—
TX
05
—
470524
—
TX
01
—
5904380
NCPDP
TX
Enumeration date
10/07/2011
Last updated
10/21/2025
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