Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens #10131
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
303 DEVEREAUX DR, NATCHEZ, MS 39120-4207
(601) 446-5810
(601) 446-5841
Mailing address
1901 E VOORHEES ST, MS #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
0702901.2
MS
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03126089
—
MS
05
—
06627777 DME
—
MS
05
—
1257508
—
LA
01
—
2586583
NCPDP
—
Enumeration date
08/16/2006
Last updated
10/09/2024
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