Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #10467
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
VIRGINIA GARZA (MANAGER)
(217) 709-2364
Entity
Organization
Contact information
Practice address
1236 N WATERMAN AVE, SAN BERNARDINO, CA 92404-5311
(909) 885-7146
(909) 889-3978
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
PHY48853
CA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417149089
—
CA
01
—
5627902
NCPDP
—
05
—
PHA488530
—
CA
Enumeration date
08/16/2007
Last updated
06/05/2024
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