Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens #01004
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
KIRA L TAYLOR (MANAGER)
(217) 709-2351
Entity
Organization
Contact information
Practice address
1625 TAYLOR RD, PORT ORANGE, FL 32128-6925
(386) 761-5578
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
PH23717
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000567600
—
FL
01
—
000567601
FL MEDICAID DME
FL
01
—
1036753
NCPDP
—
Enumeration date
07/08/2008
Last updated
10/31/2023
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