Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #11086
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
KIRA L TAYLOR (MANAGER)
(217) 709-2351
Entity
Organization
Contact information
Practice address
2229 S. MAIN ST., FORT SCOTT, KS 66701-3023
(620) 223-2402
(620) 223-4954
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
2-13132
KS
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100242740L
—
OK
01
—
100242740N
MEDICAID DME
OK
05
—
100432200E
—
KS
05
—
100432200F DME
—
KS
01
—
1719218
NCPDP
—
Enumeration date
08/05/2007
Last updated
11/06/2023
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