Organization
WALGREEN CO.
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens #11705
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
KIRA L TAYLOR (MANAGER)
(217) 709-2351
Entity
Organization
Contact information
Practice address
3019 FLOYD AVE, MODESTO, CA 95355-9604
(209) 551-4867
(209) 551-4873
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
49963
CA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437387347
—
CA
01
—
5634894
NCPDP
—
Enumeration date
06/30/2009
Last updated
10/27/2023
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