Organization
WALGREEN CO
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #15702
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
424 CALIFORNIA AVE SW, CAMDEN, AR 71701-4216
(870) 836-4157
(870) 836-0962
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
AR20119
AR
333600000X
Pharmacy
Primary
AR20119
AR
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0418017
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
10615
MEDICARE FLU
AR
05
—
134926407
—
AR
01
—
136533716
MEDICAID DME
AR
01
—
P00335262
MEDICARE RAILROAD
AR
Enumeration date
10/23/2006
Last updated
03/28/2025
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