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Organization

WALGREEN CO

Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #11559
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
1305 W CHEROKEE ST, WAGONER, OK 74467-4625
(918) 485-6688
(918) 485-6684
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4515
(847) 527-2489
(217) 709-2344

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
Primary
38-5316
OK
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100245520G
MEDICAID DME
OK
05
100245520H
OK
01
3725174
NCPDP
Enumeration date
04/29/2008
Last updated
02/09/2026
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