Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #09670
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
1132 N MAIN ST, ALTUS, OK 73521-3122
(580) 477-1316
(580) 477-2154
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
17-5164
OK
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100802090F
—
OK
01
—
100802090G
MEDICAID DME
OK
01
—
3724792
OTHER ID
—
05
—
580110
—
TX
Enumeration date
05/04/2007
Last updated
11/20/2025
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