Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC.
Other names
Walgreens Specialty Pharmacy #21215
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
309C 22ND AVE N, NASHVILLE, TN 37203-1843
(615) 321-1808
(615) 321-1815
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
00005484
TN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134530140
—
NC
05
—
1134530140
—
VA
05
—
275688
—
AL
01
—
4446642
NCPDP
TN
Enumeration date
05/13/2014
Last updated
11/06/2024
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