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Organization

WALGREEN CO

Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens Specialty Pharmacy #15198
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
1111 MEDICAL CENTER BLVD STE N116, MARRERO, LA 70072-3152
(504) 349-6185
(504) 349-6188
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
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1935937
NCPDP
05
2201131
LA
Enumeration date
11/09/2011
Last updated
11/02/2024
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