Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens #12631
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
2084 STATE ROUTE 208, MONTGOMERY, NY 12549-2611
(845) 769-9203
(845) 769-9209
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
030561
NY
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03379119
—
NY
01
—
5800962
NCPDP
NY
Enumeration date
09/01/2010
Last updated
02/10/2026
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