Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens #10631
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
14780 S HARLAN RD, LATHROP, CA 95330-9719
(209) 858-2801
(209) 858-5892
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
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHY48829
CA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306033865
—
CA
01
—
5628461
NCPDP
—
05
—
PHA488290
—
CA
Enumeration date
09/28/2007
Last updated
06/11/2024
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