Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #09158
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
5305 INDIAN RIVER RD, VIRGINIA BEACH, VA 23464-5320
(757) 467-0953
Mailing address
1901 E VOORHEES ST, MAILSTOP #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
201004042
VA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010186374
—
VA
05
—
1679580542 DME
—
VA
01
—
4838756
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/02/2006
Last updated
10/09/2024
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