Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Rite Aid #17503
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
ALYSSA SWEETEN (MANAGER)
(217) 709-2386
Entity
Organization
Contact information
Practice address
842 STATE ST, WATERTOWN, NY 13601-2843
(315) 788-8768
(315) 786-0961
Mailing address
1901 E VOORHEES ST # MS 790, DANVILLE, IL 61834-4509
(217) 709-2386
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036239
BOARD OF PHARMACY
NY
05
—
04989488
—
NY
01
—
5822259
NCPDP
NY
Enumeration date
07/21/2017
Last updated
03/07/2023
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