Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens #12822
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
1790 W GOVERNMENT ST, BRANDON, MS 39042-2411
(601) 825-3473
(601) 825-5909
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
08028/01.2
MS
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02920825
—
MS
01
—
2587624
NCPDP
MS
Enumeration date
03/31/2009
Last updated
10/09/2024
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