Organization
WALGREEN CO
Active
Parent organization
WALGREEN BOOTS ALLIANCE INC
Other names
Walgreens Specialty Pharmacy #16309
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREEN BOOTS ALLIANCE INC
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
1401 FOUCHER ST STE C-309, NEW ORLEANS, LA 70115-3515
(504) 758-3726
(504) 758-3728
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
007205
LA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1938907
NCPDP
LA
05
—
2204050
—
LA
Enumeration date
09/18/2015
Last updated
11/02/2024
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