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
1	3336C0003X	Community/Retail Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	333600000X	Pharmacy	PHY44939	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0556386	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013922392
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	:	3655 ALHAMBRA AVE
Second Line	:
City	:	MARTINEZ
State	:	CA
Zip	:	94553-3912
Country	:	US
Telephone Number	:	925-372-0337
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	:	06/09/2026

Similar Medicare Providers

1265717748 — MRS. LIDIA NADER GERGES RPH
Practice Location Address:

3655 ALHAMBRA AVE
MARTINEZ, CA
94553-3912

Practice Phone: 925-372-0337
Practice Fax: 925-372-6018

1457780264 — DR. RUNFEN YUAN PHARMD.
Practice Location Address:

3655 ALHAMBRA AVE
MARTINEZ, CA
94553-3912

Practice Phone: 925-372-0337
Practice Fax:

1821641630 — DR. BARRY TSE PHARMD
Practice Location Address:

3655 ALHAMBRA AVE
MARTINEZ, CA
94553-3912

Practice Phone: 925-372-0337
Practice Fax:

1316747157 — SHIELA MAE ROMERO MAGCAUAS RPH
Practice Location Address:

3655 ALHAMBRA AVE
MARTINEZ, CA
94553-3912

Practice Phone: 925-372-0337
Practice Fax:

1356125280 — ELIZA MRVAN LPC
Practice Location Address:

4812 TECHNOLOGY DR BLDG 1
MARTINEZ, GA
30907-3912

Practice Phone: 540-808-7454
Practice Fax:

1407788292 — DIANE LOUISE CHASE
Practice Location Address:

1340 ARNOLD DR STE 200
MARTINEZ, CA
94553-4189

Practice Phone: 925-393-2052
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.