Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Rite Aid # 17565
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
114 GAUSE BLVD W, SLIDELL, LA 70460-2625
(985) 643-6262
(985) 639-3663
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
PHY.007624-RC
LA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1940724
NCPDP
LA
05
—
2205897
—
LA
Enumeration date
08/18/2017
Last updated
06/15/2018
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