Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLLIANCE INC
Other names
Walgreens Specialty Pharmacy #16317
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLLIANCE INC
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
335 MASSACHUSETTS AVE, INDIANAPOLIS, IN 46204-2108
(317) 631-6000
(317) 631-6004
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
60006296A
IN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0064463
—
OH
01
—
1563748
NCPDP
IN
05
—
201063330A
—
IN
Enumeration date
02/14/2012
Last updated
12/04/2024
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