Organization
WALGREEN LOUISIANA CO INC
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #04566
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
2700 JOHNSTON ST, LAFAYETTE, LA 70503-3242
(337) 232-9317
Mailing address
1901 E VOORHEES ST, MAILSTOP #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
4057RC
LA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1266329
—
LA
01
—
1928122
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
690014
—
TX
Enumeration date
07/29/2006
Last updated
03/27/2025
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