Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens #15788
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
VIRGINIA GARZA (MANAGER)
(217) 709-2364
Entity
Organization
Contact information
Practice address
900 N 6TH ST, BLYTHEVILLE, AR 72315-1702
(870) 763-4507
(870) 762-0782
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(217) 709-2364
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
AR20073
AR
333600000X
Pharmacy
Primary
AR20073
AR
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0415299
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
10615
MEDICARE FLU
AR
05
—
133192407
—
AR
01
—
135626716
MEDICAID DME
AR
05
—
135626716
—
MO
05
—
608053104
—
MO
01
—
628053100
MEDICAID DME
MO
01
—
P00335262
MEDICARE RAILROAD FLU
AR
Enumeration date
10/23/2006
Last updated
06/20/2024
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