Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #12553
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
KIRA TAYLOR (MANAGER)
(217) 709-2351
Entity
Organization
Contact information
Practice address
266 E BROAD ST, CAMILLA, GA 31730-1926
(229) 336-2976
(229) 336-8509
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
PHRE009576
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000844599K
—
GA
01
—
000844599L
MEDICAID DME
GA
01
—
1158523
NCPDP
—
Enumeration date
03/26/2009
Last updated
04/04/2022
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