Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens # 10804
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
7420 SECOR RD, LAMBERTVILLE, MI 48144-9607
(734) 856-2083
(734) 856-3896
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
L1345553
MI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437325636
MI MEDICAID DME
MI
01
—
22371247
NCPDP
—
01
—
2371247
MEDICAID MI
MI
Enumeration date
05/07/2008
Last updated
02/11/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us