Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #15830
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
ALYSSA SWEETEN (MANAGER)
(217) 709-2386
Entity
Organization
Contact information
Practice address
1401 E HARDING AVE, PINE BLUFF, AR 71601-6167
(870) 536-7140
(870) 536-6513
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(217) 709-2386
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
AR09676
AR
333600000X
Pharmacy
AR09676
AR
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0409676
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
100845407
—
AR
01
—
10619
MEDICAID FLU
AR
01
—
136452716
MEDICAID DME
AR
Enumeration date
10/23/2006
Last updated
06/15/2018
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