Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Wiggins Family Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
VIRGINIA GARZA (MANAGER)
(217) 709-2364
Entity
Organization
Contact information
Practice address
1128 S PARK ST, CARROLLTON, GA 30117-4450
(770) 836-0770
(770) 836-7506
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(217) 709-2364
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
PHRE007615
GA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHRE007615
GA
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1139244
NCPDP
—
Enumeration date
03/06/2007
Last updated
07/30/2024
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