Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #15805
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
MR. ALAN T NIELSEN (TREASURER)
(847) 315-3523
Entity
Organization
Contact information
Practice address
738 S GLOSTER ST, TUPELO, MS 38801-4932
(662) 844-0432
(662) 844-9853
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(217) 709-2386
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
01443012
MS
333600000X
Pharmacy
01443/01.2
MS
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00330366
—
MS
01
—
01443012
MEDICAID DME
MS
01
—
2511714
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
330366
—
MS
01
—
870001323
MEDICARE FLU
MS
Enumeration date
10/24/2006
Last updated
03/16/2017
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