Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens #12111
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
VIRGINIA GARZA (MANAGER)
(217) 709-2364
Entity
Organization
Contact information
Practice address
14659 N US HIGHWAY 25 E STE C, CORBIN, KY 40701-5265
(606) 258-7980
(606) 258-7986
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(217) 709-2364
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
P07348
KY
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831331
NCPDP
—
01
—
1871721712
KY DME
KY
05
—
1871721712
—
KY
Enumeration date
06/30/2009
Last updated
06/19/2024
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