Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Rite Aid #4805
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
ALYSSA SWEETEN (MANAGER)
(217) 709-2386
Entity
Organization
Contact information
Practice address
2463 US ROUTE 9W, RAVENA, NY 12143
(518) 756-6131
(518) 756-2536
Mailing address
1901 E VOORHEES ST # MS 790, DANVILLE, IL 61834-4509
(217) 709-2386
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
036132
NY
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04987766
—
NY
01
—
5821815
NCPDP
NY
Enumeration date
08/18/2017
Last updated
07/26/2018
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