Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #15816
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
2401 N CENTRAL AVE, HUMBOLDT, TN 38343-1753
(731) 784-2613
(731) 784-7410
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
2132
TN
333600000X
Pharmacy
Primary
0000002132
TN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1532437
MEDICAID-DME
TN
01
—
3914212
MEDICARE FLU
TN
01
—
4427856
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
9449858
—
TN
Enumeration date
10/23/2006
Last updated
06/25/2025
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