Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #12552
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
KIRA TAYLOR (MANAGER)
(217) 709-2351
Entity
Organization
Contact information
Practice address
3805 S NOVA RD, PORT ORANGE, FL 32129-4201
(386) 756-0776
(386) 760-3827
Mailing address
1901 E VOORHEES ST, MS #790, DANVILLE, IL 61834-4509
(217) 709-2351
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PH0008347
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1046968
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
105100800
—
FL
05
—
105100801 DME
—
FL
Enumeration date
07/31/2006
Last updated
04/04/2022
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