Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens #11525
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
9372 RICHMOND HWY, LORTON, VA 22079-1827
(571) 642-0103
(571) 642-0381
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
0201004487
VA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053661876
VA DME
VA
05
—
1053661876
—
VA
01
—
4844191
NCPDP
VA
Enumeration date
09/19/2012
Last updated
06/25/2025
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