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Organization

WALGREEN CO

Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens Specialty Pharmacy #13832
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
4339 DI PAOLO CTR, GLENVIEW, IL 60025-5202
(847) 299-1920
(847) 299-1943
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
054016020
IL
3336C0003X
Community/Retail Pharmacy
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1276740
LA
01
1467516
NCPDP
05
1518982180
IA
05
1518982180
MO
05
172250002
ME
05
200841780A
IN
05
4904689
MI
05
6030399
WA
05
8532072
SD
Enumeration date
07/13/2006
Last updated
12/02/2024
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