Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INCE
Other names
Walgreens Specialty Pharmacy #16523
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INCE
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
1200 BROWN ST, STE 160, DAYTON, OH 45409
(937) 648-0312
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(847) 527-2489
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
022734550
OH
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0242691
—
OH
01
—
3684823
NCPCP
OH
Enumeration date
11/28/2016
Last updated
12/04/2024
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