Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #06361
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
1330 N WOODLAWN ST., WITCHITA, KS 67208-2647
(316) 684-2828
(316) 684-4450
Mailing address
1901 E VOORHEES, 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
2-13085
KS
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100432240A
MEDICAID DME
KS
05
—
100432240B
—
KS
01
—
1715296
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/01/2006
Last updated
07/09/2025
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