Organization
WALGREEN CO.
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Center for Living Well Family Health Care
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
960 BACK STAGE LN, LAKE BUENA VISTA, FL 32830-8472
(407) 934-2030
(407) 934-2031
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
—
—
333600000X
Pharmacy
Primary
PH23619
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002683800
—
FL
01
—
002683801
MEDICAID DME
FL
01
—
1037212
NCPDP
—
Enumeration date
04/24/2008
Last updated
04/11/2022
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