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	332B00000X	Durable Medical Equipment & Medical Supplies
2	291U00000X	Clinical Medical Laboratory
3	3336C0003X	Community/Retail Pharmacy
4	333600000X	Pharmacy	10669	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	4502161	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

General Provider Information

NPI Number	:	1184631103
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	:	4841 MOUNT HOUSTON RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77093-1632
Country	:	US
Telephone Number	:	281-442-6392
Fax Number	:	281-442-6575

Authorized Official
Title or Position	:	MANAGER
Name	:	JENNIFER PONCE
Credential	:
Telephone Number	:	847-527-2489

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	05/22/2026

Similar Medicare Providers

1750618880 — DR. NAOMI ODETTE IZQUIERDO PHARM.D.
Practice Location Address:

4841 MOUNT HOUSTON RD
HOUSTON, TX
77093-1632

Practice Phone: 281-442-6392
Practice Fax: 281-442-6575

1679886063 — MRS. EUNICE CHARLOTTE BOYD-LOTT B.S.
Practice Location Address:

4841 MOUNT HOUSTON RD
HOUSTON, TX
77093-1632

Practice Phone: 281-442-6392
Practice Fax:

1598243974 — MANAL EL-KHALIL
Practice Location Address:

4841 MOUNT HOUSTON RD
HOUSTON, TX
77093-1632

Practice Phone: 281-442-6392
Practice Fax:

1568038040 — SLEEP HOUSTON, PLLC
Practice Location Address:

9099 KATY FWY STE 100
HOUSTON, TX
77024-1632

Practice Phone: 713-828-8587
Practice Fax: 866-420-8578

1477543122 — DR. JAYASIMHA N MURTHY MD
Practice Location Address:

6560 FANNIN ST STE 1632
HOUSTON, TX
77030-2734

Practice Phone: 713-255-4000
Practice Fax: 713-255-4050

1063464402 — PULMONARY CRITICAL CARE AND SLEEP MEDICINE CONSULTANTS, LLP
Practice Location Address:

6560 FANNIN ST STE 1632
HOUSTON, TX
77030-2734

Practice Phone: 713-255-4066
Practice Fax: 713-255-4050

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.