Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE
Other names
Walgreens Specialty Pharmacy #15320
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
4101 GREENBRIAR DR STE 235, HOUSTON, TX 77098
(713) 521-1700
(713) 521-5855
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
27963
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100230880D
—
OK
05
—
466816
—
TX
05
—
469320
—
TX
01
—
5905584
NCPDP
—
Enumeration date
02/02/2012
Last updated
11/01/2024
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