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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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