Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #11107
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
VIRGINIA GARZA (MANAGER)
(217) 709-2364
Entity
Organization
Contact information
Practice address
501 US HIGHWAY 84 E, CAIRO, GA 39828-1852
(229) 377-5510
(229) 377-5515
Mailing address
1901 E VOORHEES ST, MS #790, DANVILLE, IL 61834-4509
(217) 709-2364
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHRE009477
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1156985
NCPDP
—
05
—
795876151A
—
GA
01
—
795876151B
MEDICAID DME
GA
Enumeration date
02/11/2008
Last updated
06/19/2024
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