Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens #12749
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
900 EASTLAND DR, JEFFERSON CITY, MO 65101-3894
(573) 556-5615
(573) 556-8749
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
2010007861
MO
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255660346
—
IA
01
—
2638952
NCPDP
MO
05
—
606469500
—
MO
Enumeration date
12/18/2009
Last updated
02/10/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us