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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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail Pharmacy
3333600000XPharmacy031820NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25806700OTHERNYNCPDP
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568700961
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALGREEN CO
Provider Business Mailing Address
First Line : 1901 E VOORHEES ST # MS 790
Second Line :
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 : 1281 FULTON ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11216-2011
Country : US
Telephone Number : 718-398-2074
Fax Number : 718-398-3081
Authorized Official
Title or Position : MANAGER
Name : JENNIFER PONCE
Credential :
Telephone Number : 847-527-2489
Provider Enumeration Date : 01/21/2013
Last Update Date : 06/16/2026

Similar Medicare Providers

1801119920 — MOHAMMED OBAIDULLAH PHARM. D
Practice Location Address:
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1134447691 — MR. CHI YAN MUI PHARMD
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1588261499 — DESHLIKA BARUA PHARMD.
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Practice Fax:
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Practice Location Address:
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1295714020 — DR. MARIO JOSEPH MANNA DO
Practice Location Address:
7318 13TH AVE
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Practice Fax: 718-630-1406

Directions to “WALGREEN CO ” Practice Location

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