Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Bennett Apothecary #15738, Powered by Walgreens
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
ALYSSA SWEETEN (MANAGER)
(217) 709-2386
Entity
Organization
Contact information
Practice address
2049 E SHILOH RD, CORINTH, MS 38834-3726
(662) 286-6914
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(217) 709-2386
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
01049011
MS
3336C0004X
Compounding Pharmacy
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00045061
—
MS
05
—
0093009
—
MS
01
—
2508224
NABP
MS
01
—
2508224
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
512G730016
MEDICARE FLU PTAN
—
Enumeration date
10/31/2006
Last updated
06/15/2018
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