Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens Specialty Pharmacy #13100
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
1601 E 19TH AVE, STE 4650, DENVER, CO 80218-1253
(303) 656-4656
(303) 656-4661
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
PDO-790
CO
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0621335
NCPDP
CO
05
—
1326278185
—
IA
05
—
246608200
—
WY
05
—
36207276
—
CO
Enumeration date
07/15/2009
Last updated
11/10/2025
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