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	10612	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	4566595	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	:	1528073525
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	:	1120 N LOOP 336 W
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77301-1156
Country	:	US
Telephone Number	:	936-760-4116
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	:	11/24/2025

Similar Medicare Providers

1932758042 — ELIZABETH KAY SMITH FNP-BC
Practice Location Address:

1120 N LOOP 336 W STE A
CONROE, TX
77301-1156

Practice Phone: 346-646-4220
Practice Fax: 713-461-5307

1962676965 — MEMORIAL HERMANN HEALTH SYSTEM
Practice Location Address:

1150 N LOOP 336 W
CONROE, TX
77301-1156

Practice Phone: 936-442-2633
Practice Fax: 713-338-4158

1164675807 — MEMORIAL HERMANN HEALTH SYSTEM
Practice Location Address:

1150 N LOOP 336 W
CONROE, TX
77301-1156

Practice Phone: 936-442-2633
Practice Fax: 713-338-4158

1194001701 — DR. MOSES ANOS UBAECHU
Practice Location Address:

1120 N LOOP 336 W
CONROE, TX
77301-1156

Practice Phone: 936-760-4116
Practice Fax: 936-760-4071

1023447497 — STEPHEN DANIEL HOLLEK DPT
Practice Location Address:

1150 N LOOP 336 W
CONROE, TX
77301-1156

Practice Phone: 936-494-3777
Practice Fax: 936-494-3788

1558756445 — SHAWN PRATT PTA
Practice Location Address:

1150 N LOOP 336 W
CONROE, TX
77301-1156

Practice Phone: 814-494-3777
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.