Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #10162
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
1716 PLEASANT RD, FORT MILL, SC 29708-7815
(803) 802-7644
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
50-009289
SC
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4226747
NCPDP
—
05
—
712744
—
SC
01
—
DE2892
MEDICAID DME
SC
Enumeration date
03/28/2007
Last updated
09/08/2025
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