Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #10454
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
1071 N MAIN ST, MANTECA, CA 95336-3744
(209) 825-5481
(209) 825-6998
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
—
—
333600000X
Pharmacy
Primary
PHY37541
CA
3336C0003X
Community/Retail Pharmacy
PHY37541
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0566642
OTHER ID NUMBER
—
05
—
1245245539
—
CA
05
—
PHA375410
—
CA
Enumeration date
07/29/2006
Last updated
06/25/2025
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