Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens #15361
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
2503 W 28TH AVE, PINE BLUFF, AR 71603-5053
(870) 850-6084
(870) 850-6361
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
AR20702
AR
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0409450
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
100633407
—
AR
01
—
10619
MEDICARE FLU
AR
01
—
127143716
MEDICAID DME
—
Enumeration date
10/23/2006
Last updated
09/10/2025
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