Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens Specialty Pharmacy #12805
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
499 E HAMPDEN AVE, STE 150, ENGLEWOOD, CO 80113-3875
(303) 524-3750
(303) 524-3762
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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PDO-37000045
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0621044
NCPDP
CO
05
—
494573
—
AZ
05
—
50255550
—
CO
Enumeration date
06/06/2008
Last updated
10/02/2025
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