Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE
Other names
Walgreens Specialty Pharmacy #16078
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
205 8TH AVE, NEW YORK, NY 10011-1617
(212) 691-9050
(212) 691-9052
Mailing address
1901 E VOORHEES ST, MS #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
031226
NY
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03479554
—
NY
01
—
5804770
NCPDP
NY
Enumeration date
02/02/2012
Last updated
09/02/2025
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