Organization
WALGREEN CO
Active
Parent organization
WALGREENS HOLDING COMPANY
Other names
Walgreens #10907
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS HOLDING COMPANY
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
1410 N BLUFF ST, FULTON, MO 65251-2350
(573) 592-7030
(573) 592-7399
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4515
(847) 527-2489
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
208019420
MO
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2637758
NCPDP
MO
05
—
606381408
—
MO
Enumeration date
12/18/2007
Last updated
07/22/2026
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