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Organization

WALGREEN CO

Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #15714
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
500 S UNIVERSITY AVE, LITTLE ROCK, AR 72205-5302
(501) 664-4121
(501) 661-9831
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
AR20067
AR
333600000X
Pharmacy
AR20067
AR
3336C0003X
Community/Retail Pharmacy
Primary
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0401062
OTHER ID NUMBER-COMMERCIAL NUMBER
01
10615
MEDICAID FLU
AR
05
133325407
AR
01
135621716
MEDICAID DME
AR
01
P00335262
MEDICARE RAILROAD
AR
Enumeration date
10/24/2006
Last updated
03/28/2025
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