Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE
Other names
Walgreens Specialty Pharmacy #11401
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
7777 FOREST LN STE A062, DALLAS, TX 75230-6881
(972) 661-0835
(972) 661-3176
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
25625
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4545010
NCPDP
—
05
—
466414
—
TX
05
—
470840
—
TX
Enumeration date
05/23/2007
Last updated
10/20/2025
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