Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #09593
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
3499 BELLA VISTA WAY, BELLA VISTA, AR 72714-5740
(479) 273-9136
(479) 273-9155
Mailing address
1901 E VOORHEES ST, MS 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
AR20510
AR
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0422181
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
1245245513
MEDICAID MO
MO
05
—
158111716 DME
—
AR
05
—
158294407
—
AR
05
—
606375400
—
MO
Enumeration date
07/29/2006
Last updated
10/25/2023
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