Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #15751
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
1920 SE WASHINGTON BLVD, BARTLESVILLE, OK 74006-6736
(918) 335-4305
(918) 335-4308
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
94177
OK
333600000X
Pharmacy
94177
OK
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100241490P
—
OK
01
—
200077890O
MEDICAID DME
OK
01
—
3721087
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
400522489
MEDICARE FLU
OK
Enumeration date
10/25/2006
Last updated
03/28/2025
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