Organization
WALGREEN CO
Active
Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #15789
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
701 W GROVE ST, EL DORADO, AR 71730-4415
(870) 881-8434
(870) 881-8448
Mailing address
1901 E VOORHEES ST # MS 790, DANVILLE, IL 61834-4515
(847) 527-2489
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
AR20056
AR
333600000X
Pharmacy
AR20056
AR
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0418942
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
10615
MEDICARE FLU
AR
05
—
133285407
—
AR
01
—
135604716
MEDICAID DME
AR
01
—
P00335262
MEDICARE RAILROAD FLU
AR
Enumeration date
10/23/2006
Last updated
06/25/2025
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