Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
RITE AID #1671
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
ALYSSA SWEETEN (MANAGER)
(217) 709-2386
Entity
Organization
Contact information
Practice address
1103 W SCREVEN ST, QUITMAN, GA 31643
(229) 263-4455
(229) 263-6483
Mailing address
1901 E VOORHEES ST # MS 790, DANVILLE, IL 61834-4509
(217) 709-2386
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHRE010500
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00313167A
—
GA
01
—
1170579
NCPDP
GA
Enumeration date
07/26/2017
Last updated
04/30/2018
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