Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #01679
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
6411 GRAVOIS AVE, SAINT LOUIS, MO 63116-1123
(314) 832-3650
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(847) 527-2489
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
4629
MO
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2623420
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
602291700
—
MO
01
—
622291706
DME
MO
Enumeration date
08/01/2006
Last updated
06/16/2025
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