Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Rite Aid #10403
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
67 SAINT GEORGE AVE, ROSELLE, NJ 07203-2916
(908) 298-1304
(908) 298-1378
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
28RS00648400
NJ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0617148
—
NJ
01
—
3192678
NCPDP
NJ
Enumeration date
08/03/2017
Last updated
04/19/2019
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