Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #07578
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
1710 W DEYOUNG ST, MARION, IL 62959-1054
(618) 998-1603
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
—
—
333600000X
Pharmacy
Primary
054.019205
IL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1476363
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
1831104041
—
KY
05
—
606219905
—
MO
05
—
626219901 DME
—
MO
05
—
9001176800 DME
—
KY
Enumeration date
07/29/2006
Last updated
11/24/2025
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