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Organization

WALGREEN CO

Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #11632
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
2150 FAIRGROUNDS RD NE, SALEM, OR 97301-0641
(503) 428-5107
(503) 428-5113
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
RP-0002487-CS
OR
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
025223
OR
01
025297
MEDICAID DME
OR
01
3843148
NCPDP
Enumeration date
05/07/2008
Last updated
08/06/2025
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