Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens #21165
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
971 LAKELAND DR STE 101, JACKSON, MS 39216-4607
(601) 718-1898
(601) 718-1899
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
17010
MS
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08977310
—
MS
01
—
2591611
NCPDP
MS
Enumeration date
01/29/2018
Last updated
06/13/2022
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