Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #15721, WALGREENS #21379
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
KIRA TAYLOR (MANAGER)
(217) 709-2351
Entity
Organization
Contact information
Practice address
5905 DOLLARWAY RD, PINE BLUFF, AR 71602-3825
(870) 534-7868
(870) 534-4677
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(217) 709-2351
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
AR13930
AR
333600000X
Pharmacy
AR13930
AR
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0413930
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
118502407
—
AR
01
—
123697716
MEDICAID DME
AR
01
—
48624
MEDICARE FLU
AR
Enumeration date
10/25/2006
Last updated
05/04/2022
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