Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #10908
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
6 S PERRYVILLE BLVD, PERRYVILLE, MO 63775-1267
(573) 517-0029
(573) 517-0319
Mailing address
1901 E VOORHEES ST # 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
2007033414
MO
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2637544
NCPDP
—
01
—
606345403
MO MEDICAID
MO
01
—
626345409
MO MEDICAID DME
MO
Enumeration date
08/06/2007
Last updated
06/25/2025
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