Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #05372
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
KIRA L TAYLOR (MANAGER)
(217) 709-2351
Entity
Organization
Contact information
Practice address
16108 FOOTHILL BLVD, FONTANA, CA 92335-3356
(909) 357-6900
(909) 357-1756
Mailing address
1901 E VOORHEES ST, MAILSTOP #790, DANVILLE, IL 61834-4509
(217) 709-2351
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHY44289
CA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0517308
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
1174538441
—
CA
05
—
PHA442890
—
CA
Enumeration date
07/29/2006
Last updated
04/26/2022
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