DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: WALGREEN CO

MEDICARE: WALGREEN CO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacy3689MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22616689OTHERNCPDP
32616689OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1003821240
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALGREEN CO
Provider Business Mailing Address
First Line : 1901 E VOORHEES ST
Second Line : MS 790
City : DANVILLE
State : IL
Zip : 61834-4515
Country : US
Telephone Number : 847-527-2489
Fax Number : 217-709-2344
Provider Business Practice Location Address
First Line : 7501 OLIVE BLVD
Second Line :
City : UNIVERSITY CITY
State : MO
Zip : 63130-1602
Country : US
Telephone Number : 314-725-6133
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : JENNIFER PONCE
Credential :
Telephone Number : 847-527-2489
Provider Enumeration Date : 07/29/2006
Last Update Date : 02/06/2026

Similar Medicare Providers

1164705208 — MS. KILINYAA LOUISE COTHRAN RPH
Practice Location Address:
7501 OLIVE BLVD
UNIVERSITY CITY, MO
63130-1602
Practice Phone: 314-725-6133
Practice Fax:
1619251451 — MRS. ASHLEY A MOON PHARM.D.
Practice Location Address:
7501 OLIVE BLVD
UNIVERSITY CITY, MO
63130-1602
Practice Phone: 314-725-6133
Practice Fax:
1124302641 — DR. BONITA TORBERT PHARM.D.
Practice Location Address:
7501 OLIVE BLVD
UNIVERSITY CITY, MO
63130-1602
Practice Phone: 314-725-6133
Practice Fax:
1366726366 — DR. LATOSHA MONIQUE REED PHARM.D.
Practice Location Address:
7501 OLIVE BLVD
UNIVERSITY CITY, MO
63130-1602
Practice Phone: 314-725-6133
Practice Fax:
1972900819 — DR. DARIO N. TOMAS PHARM. D.
Practice Location Address:
7501 OLIVE BLVD
UNIVERSITY CITY, MO
63130-1602
Practice Phone: 314-725-6133
Practice Fax:
1316324171 — HALEY WRAY PHARMD
Practice Location Address:
7501 OLIVE BLVD
UNIVERSITY CITY, MO
63130-1602
Practice Phone: 314-725-6133
Practice Fax:

Directions to “WALGREEN CO ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.